To evaluate the impact of successive WHO classifications on glioma diagnostic accuracy in a high-volume neurosurgical center in Latin America, highlighting the significance of these findings for resource-limited settings.
Key Findings:
Under WHO 2007 criteria, glioblastoma was the most common tumor type with nearly complete histological classification, indicating a baseline for diagnostic accuracy.
WHO 2016 implementation saw an increase in tumors labeled as 'not otherwise specified' (NOS) and incomplete characterizations, suggesting challenges in adapting to new criteria.
WHO 2021 highlighted diagnostic limitations, with 24% of tumors categorized as high- or low-grade glioma NOS, emphasizing the need for improved molecular testing access.
Interpretation:
The progressive complexity of glioma classification with new molecular factors has led to increased cases of inadequate tumor characterization due to limited access to molecular studies, underscoring the need for systemic changes in diagnostic practices.
Limitations:
Limited access to molecular testing in resource-limited settings, which directly impacts diagnostic accuracy.
Reliance on external laboratories causing delays and increased costs, further complicating timely and accurate diagnoses.
Conclusion:
The study underscores the challenges faced in achieving accurate glioma diagnosis in resource-limited settings, emphasizing the urgent need for improved access to molecular testing to fully implement WHO classification criteria.
by Pablo S. Paolinelli, Tomas Saavedra Azcona, Florencia B. Casto, Ezequiel Jungberg, Nicolás Tilano, William A. Blettler, Joan S. Pazos, Silvina Dell’Era, Clara Lynch, Miguel Villaescusa, Pedro Plou, Pablo Ajler
