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Summary
43
• Substantial step forward & paradigm change
• Introduction of molecular parameters
• Challenge molecular marker testing!
• Associated changes of diagnostic format
• Integrated diagnoses (CAVE time delay to molecular results)
• Greatest impact on diffuse gliomas & embryonal tumors
• More objective and precisely defined entities for enhanced patient
management
Reactions
44
Outlook next WHO classification
45
• Diffuse gliomas
• WHO grading system will be revised
• Pediatric low-grade gliomas
• Integrated diagnoses will be introduced, e.g., for
BRAF
gene fusion
in pilocytic astrocytomas
• Ependymoma
• WHO grading will be revised
• Meningioma
• WHO grading will be revised
• DNA methylation profiling might be introduced (?)
Asking neuropathologists in 2016
post
WHO
46
11
th
European Congress of Neuropathology, Bordeaux, France
Aim:
Assessing practice patterns regarding adult diffuse glioma during times of
transition
• Whichmolecular markers have already been incorporated in routine practice
• Whichmolecular techniques are in daily use or will be implemented in the near future
• Set a baseline for future assessments
Methods:
Structured survey distributed onsite and among Euro-CNS members
130 Respondents from 40 countries
47
No of respondents
0 1
2-4 5-14 15+
• 93.8 % indicate to work as (neuro-
)pathologist
• 75 % report to work within Europe
• Single respondents from 17 different
countries (in red)
Woehreretal,ClinNeuropathol2017
48
1. How would you rate the relevance of molecular marker
testing in diagnostic neuropathology?
0 25 50 75 100
%
Very important
Important
Something to consider
Not important
Yes Occasionally No
0 25 50 75 100
2. Do you currently use
molecular information
for diagnostic purposes?
3. Do you use
„oligoastrocytoma“ as
histological diagnosis?
%
Woehreretal,ClinNeuropathol2017