The introduction of the new classification represents the first step in the switch of paradigm in brain tumor management toward an individualized-based treatment from the, nowadays, evidence-based management.
This must also be seen as a model for diagnosis setting in the new molecular era. The implementation of this new concept in clinical practice will improve patient management, as well as the design of clinical trials and experimental studies. The family tree was redefined by the presence of the IDH mutation and of the 1p/19q codeletion. Currently, the diffuse gliomas (oligodendroglial or astrocytic) are nosologically closer than the astrocytomas with a diffuse growth pattern, and the astrocytomas with a more circumscribed growth pattern defined by the presence of the IDH mutation. While it is still impossible to disregard the histopathological component, according to the new rule (“molecular beats histology”) makes molecular parameters dominant in the final diagnosis. A new concept of “integrated diagnosis” comes to combine the classical diagnosis with the molecular one. Together with embryonal tumors, the diffuse gliomas have suffered significant changes in diagnosis, prognosis, and response to treatment. For the first time, the WHO classification of brain tumors has introduced molecular parameters in the diagnosis of brain tumors.
0 kommentar(er)
