61 EVALUATING CLINICAL AND BIOLOGICAL DETERMINANTS OF TREATMENT STRATEGY AND OUTCOMES IN GRADE 2 ADULT-TYPE DIFFUSE GLIOMAS: A RETROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Abstract BACKGROUND Two adult-type diffuse gliomas include IDH-mutant astrocytomas and IDH-mutant, 1p/19q-codeleted oligodendrogliomas. After maximal safe resection, patients undergo either a watch-and-wait strategy or upfront treatment with radiotherapy and chemotherapy. This study examined patient and tumour factors influencing clinical decision-making and outcomes. METHODS Patients with grade 2 gliomas resected between January 2012 and December 2022 were retrospectively reviewed. Demographics, tumour characteristics, and treatment details were collected to identify factors influencing initial decisions and survival. Physician consultation notes and tumour board discussions were reviewed to provide descriptive context for clinical decisions. Kaplan-Meier survival analyses were performed, with comparisons using log-rank tests (p < 0.05). RESULTS To date, 100 eligible patients have been identified. Key patient factors influencing clinical decisions included age >40 (48% watch-and-wait vs. 61% upfront treatment) and pre-surgical neurological symptoms (94% vs. 100%). Tumour factors included histology (62% vs. 46%), size >6 cm (23% vs. 39%), Ki67 (35% vs. 24%), MRI evidence of midline crossing (2% vs. 13%, p < 0.05), residual tumour (71% vs. 91%, p < 0.05), and contrast enhancement (13% vs. 33%, p < 0.05). mPFS was 5.0 years in the watch-and-wait vs. NR in the upfront treatment group. mOS was not reached in either group. CONCLUSION Patient and tumour factors play a critical role in clinical decision-making. MRI findings such as midline crossing, residual tumour, and contrast enhancement were significantly associated with treatment strategies. These findings highlight their importance in managing grade 2 gliomas, particularly as the treatment landscape continues to evolve with vorasidenib. ACKNOWLEDGEMENTS: Biennial Canadian Neuro-Oncology Meeting www.cnomeeting.ca AWARDS provided by: Brain Tumour Foundation of Canada www.braintumour.ca Brain Cancer Canada www.braincancercanada.ca BC Cancer Foundation https://bccancerfoundation.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".