Onco Wiki / Bandeira vermelha

Low-grade glioma with high-risk molecular features: IDH-wildtype (per WHO 5th ed., reclas...

Visão determinística da entidade fonte YAML. A autoridade clínica permanece com os IDs de fonte citados e estado de assinatura do revisor.

IDRF-GLIOMA-LOW-GRADE-HIGH-RISK-BIOLOGY
TipoSinal de alerta
Estadoreviewed 2026-04-27 | pending_clinical_signoff
DoençasDIS-GLIOMA-LOW-GRADE
FontesSRC-EANO-GBM-2024 SRC-NCCN-CNS-2025 SRC-WHO-LNSC-2023

Origem da bandeira vermelha

DefiniçãoLow-grade glioma with high-risk molecular features: IDH-wildtype (per WHO 5th ed., reclassified as glioblastoma molecular features even if histologically low-grade), CDKN2A/B homozygous deletion, TERT-promoter mutation in IDH-wildtype, or 1p/19q intact astrocytoma with poor risk score
Direcção clínicaintensificar
Categoriahigh-risk-biology

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "idh_wildtype",
      "value": true
    },
    {
      "finding": "cdkn2a_b_homozygous_deletion",
      "value": true
    },
    {
      "finding": "tert_promoter_mutation",
      "value": true
    },
    {
      "finding": "histology_grade_3_features",
      "value": true
    }
  ],
  "type": "composite"
}

Notas

Per WHO 5th ed.: IDH-wildtype diffuse astrocytoma with EGFR amp / +7-10 / TERT-promoter mutation is reclassified as "glioblastoma, IDH-wildtype" regardless of histology grade — these patients are managed under GBM (DIS-GBM) algorithm, not LGG. Per EANO 2024 + NCCN-CNS LGG: CDKN2A/B homozygous deletion in IDH-mut astrocytoma confers grade 4 behavior. Direction INTENSIFY — shifts to GBM-like management (Stupp protocol or aggressive RT + chemotherapy). STUB — requires clinical co-lead signoff.

Usado por

Indicação