528P - Progression risk after pregnancy in patients with glioma

Background

A significant proportion of women with diffuse gliomas are diagnosed in childbearing-age, resulting in the desire of patients to fulfil their family dream. However, data on glioma progression after and during pregnancy are sparse and controversial.

Methods

Female adult patients in their reproductive years (≥18 years and <46 years) with histopathological diagnosis of WHO grade 2 or 3 glioma from 2 academic centres between 01/01/2000 and 01/01/2019 have been included in the study. Diagnosis was updated according to WHO classification of CNS Tumours 2021 by a board-certified neuropathologist. Association of pregnancy and glioma progression was assessed in a time-dependent manner. The following parameters were included in the multivariate analysis: ECOG, extent of resection, WHO grading, adjuvant therapy after surgery, pregnancy after diagnosis.

Results

Of 159 women after a median follow up (FU) of 127.4 months (mo), 47 (29.6 %) were identified as nullipara, 89 (56 %) as primi-/multipara before glioma diagnosis and 23 (14.5 %) as primi-/multipara after diagnosis. Updated diagnosis according to latest WHO classification revealed 92 (57.8 %) astrocytomas (isocitrate dehydrogenase [IDH]-mutant) CNS WHO grade 2 and 3, 54 (33.9 %) oligodendrogliomas (IDH-mutant, 1p/19q codeleted) CNS WHO grade 2 and 3, 11 (7.1 %) glioblastomas (IDH-wildtype) CNS WHO grade 4, and 2 (1.3 %) diffuse midline gliomas (H3-K27-altered). Median overall survival (OS) and progression free survival (PFS) was 247.6 mo (95 % CI 155.7 – 339.5) and 67.9 mo (95 % CI 60.1 – 75.7), respectively. Among 23 patients with glioma diagnosis prior to pregnancy, mean time between diagnosis and conception was 54.6 mo (0.6 – 116 mo). Tumor progression happened in 17 (73.9 %) cases and death occurred in 4 (17.4 %) patients. Mean time from start of pregnancy to date of tumor progression/last-FU or death/last-FU was 35.3 mo (9 – 229.2 mo) and 107.2 mo (17.7 – 229.2 mo), respectively. In multivariate time-dependent analysis, pregnancy after diagnosis in comparison to nullipara or pregnancy before diagnosis was associated with shorter PFS (p ≤0.05), but not with shorter OS (p>0.05).

Conclusions

Pregnancy after glioma diagnosis is associated with shorter PFS. Longer follow up as well as larger cohorts are needed to investigate a potential impact on OS.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.