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We evaluated prognostic factors of adult low-grade glioma (LGG) according to the new 2016 WHO classification. Records of 153 patients diagnosed with WHO grade II LGG between 2003 and 2015 were retrospectively reviewed. Based on the 2016 WHO classification, 80 patients (52.3%) had diffuse astrocytoma,  IDH -mutant; 45 (29.4%) had oligodendroglioma,  IDH -mutant and 1p/19q-codeleted (ODG); and 28 (18.3%) had diffuse astrocytoma,  IDH -wildtype. Gross total resection (GTR) was performed in 71 patients (46.4%), subtotal resection in 31 (20.3%), partial resection in 43 (28.1%), and biopsy in 8 (5.2%). One hundred two patients (66.7%) received postoperative radiotherapy. The 5- and 10-year progression-free survival (PFS) rates were 72.7% and 51.5%, respectively, and the 5- and 10-year overall survival (OS) rates were 82.5% and 63.5%, respectively. GTR and  IDH -mutant and/or 1p/19q codeletion were favorable prognostic factors for PFS and OS. Patients with  IDH -wildtype had significantly decreased OS. Among patients with ODG who underwent GTR, no recurrence was observed after radiotherapy. Patients who underwent non-GTR frequently experienced recurrence after radiotherapy ( IDH -mutant: 47.6%,  IDH -wildtype: 57.9%). In conclusion, molecular classification of LGG was of prognostic relevance, with  IDH -wildtype patients having a particularly poor outcome, regardless of the treatment. Favorable results were observed in patients who underwent GTR.

Extent of resection and molecular pathologic subtype are potent prognostic factors of adult WHO grade II glioma