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September 2, 2026Medical Journal of Western Black SeaOpen Access

Incremental prognostic value of isocitrate dehydrogenase status and O⁶-Methylguanine-DNA methyltransferase promoter methylation beyond World Health Organization grade in adult diffuse glioma: A real-world cohort study

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Authors

BABerkay AyhanATAyhan TekinerMYMehmet Emre Yıldırım

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Overview

Retrospective cohort study reveals tumor grade and IDH status drive risk discrimination in adult diffuse glioma, indicating limited added prognostic value from MGMT methylation.

Key Points

  • To assess the incremental prognostic contribution of isocitrate dehydrogenase (IDH) status and MGMT promoter methylation beyond clinical factors and World Health Organization (WHO) grade in adult diffuse glioma.
  • Conducted a retrospective single-center cohort study of 82 adults who underwent glioma surgery between 2017 and 2022.
  • Evaluated three prespecified nested Cox models comparing clinical variables alone, clinical variables plus WHO grade, and the full model including IDH and MGMT molecular markers.
  • Assessed model discrimination, calibration, reclassification, and bootstrap optimism correction, alongside a prespecified IDH-wildtype subgroup analysis.
  • Optimism-corrected concordance improved from 0.701 for clinical variables alone to 0.829 after adding WHO grade, and reached 0.834 with the addition of IDH and MGMT markers.
  • WHO grade accounted for the primary gain in discrimination, while IDH-wildtype status persisted as the dominant adverse molecular feature.
  • MGMT promoter methylation showed no independent prognostic association in either the mixed cohort or the IDH-wildtype subgroup.

Cite This Study

Ayhan et al. (2026) studied this question.

synapsesocial.com/papers/6a97e2b1c562ede874ec6f4ahttps://doi.org/10.29058/mjwbs.1973514
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1IDH wild-type glioblastoma: Predictive value of standard-of-care (SOC) MRI for establishing MGMT promoter methylation status2025 · 1 citations
  2. 2Clinical impact of IDH1 mutations and MGMT methylation in adult glioblastoma2024 · 4 citations
  3. 3Unveiling hierarchy and spatial distribution of O<sup>6</sup>‐methylguanine‐DNA methyltransferase promoter methylation in World Health Organization grade 2–3 gliomas2024 · 1 citations
  4. 4F.3 Multicentre prospective validation of integrated molecular classification of meningiomas and prediction of recurrence risk using DNA methylation2024
  5. 5Predictive role of MGMT and IDH status in the efficacy of bevacizumab for high-grade glioma: a retrospective study2025