{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:50:40Z","timestamp":1791568240836,"version":"4.3.4"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"abstract":"<jats:p>\n                    Diffuse gliomas are the most common malignant brain tumors in adults, stratified by isocitrate dehydrogenase (\n                    <jats:italic toggle=\"yes\">IDH1\/IDH2<\/jats:italic>\n                    ) mutation status. While the median age for central nervous system (CNS) World Health Organization (WHO) grade 2 to 3 IDH-mutant astrocytomas is 38 years, older patients of &gt;55 years predominantly exhibit IDH-wildtype gliomas and confer a poorer prognosis. To examine the clinicopathologic spectrum of IDH-mutant astrocytomas in older adults, we retrospectively reviewed all astrocytic tumors diagnosed at our institution between 2021 and 2024 in patients &gt;55 years. Twenty-two IDH-mutant astrocytomas (median age: 63 years; range: 56-79; male:female\u2009=\u20099:13) were identified and compared descriptively to a historical cohort of 179 IDH-mutant astrocytomas in younger patients. Grade distribution among older patients paralleled that of younger adults: CNS WHO grade 2 (55%), grade 3 (18%), and grade 4 (27%). Magnetic resonance imaging (MRI) showed T2\/FLAIR mismatch sign in 25% of grade 2 tumors and in none of the higher grades; 50% of grade 2 tumors demonstrated contrast enhancement. IDH1 p.R132H accounted for 95% of mutations, with 1 p.R132G variant. ATRX loss was seen in 71% and strong p53 immunoreactivity in 83% of evaluable tumors. Copy-number analysis (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200910) revealed\n                    <jats:italic toggle=\"yes\">CDKN2A\/B<\/jats:italic>\n                    homozygous deletion in 10% and heterozygous loss in 20%\n                    <jats:italic toggle=\"yes\">.<\/jats:italic>\n                    Despite their rarity, IDH-mutant astrocytomas in older adults are more prevalent than historically appreciated and maintain imaging and molecular profiles akin to tumors in younger adults. Accordingly, IDH1 p.R132H-specific immunohistochemistry remains a cost-effective first-line screening tool irrespective of age.\n                  <\/jats:p>","DOI":"10.1177\/10668969261489616","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:08:00Z","timestamp":1791389280000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["IDH-Mutant Astrocytomas in Patients Older than 55 Years: A Retrospective Analysis"],"prefix":"10.1177","author":[{"given":"Rasha","family":"Alfattal","sequence":"first","affiliation":[{"name":"Houston Methodist Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keng","family":"Lam","sequence":"additional","affiliation":[{"name":"City of Hope"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanim I.","family":"Ozkizilkaya","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0787-0634","authenticated-orcid":false,"given":"Chirag B.","family":"Patel","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Wang","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason T.","family":"Huse","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leomar Y.","family":"Ballester","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-7958","authenticated-orcid":false,"given":"Maria A.","family":"Gubbiotti","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab106"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-013-0345-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.4008"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402121"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.1789"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.0002"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-022-04230-1"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3171\/2023.6.JNS222907"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2020.151653"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07467-4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210825"},{"issue":"2","key":"e_1_3_2_13_2","first-page":"151","article-title":"IDH1-mutation in diffuse gliomas in persons age 55 years and over","volume":"76","author":"Robinson C","year":"2017","unstructured":"Robinson C, Kleinschmidt-DeMasters BK. IDH1-mutation in diffuse gliomas in persons age 55 years and over. J Neuropathol Exp Neurol. 2017;76(2):151-154.","journal-title":"J Neuropathol Exp Neurol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noae238"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/neup.12608"},{"issue":"12","key":"e_1_3_2_16_2","first-page":"1519","article-title":"CDKN2A Homozygous deletion is a strong adverse prognosis factor in diffuse malignant IDH-mutant gliomas","volume":"21","author":"Appay R","year":"2019","unstructured":"Appay R, Dehais C, Maurage CA, et al. CDKN2A Homozygous deletion is a strong adverse prognosis factor in diffuse malignant IDH-mutant gliomas. Neuro Oncol. 2019;21(12):1519-1528.","journal-title":"Neuro Oncol"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-018-03034-6"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-0560"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A8783"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noae145"}],"container-title":["International Journal of Surgical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10668969261489616","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10668969261489616","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10668969261489616","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:00:11Z","timestamp":1791565211000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10668969261489616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":19,"alternative-id":["10.1177\/10668969261489616"],"URL":"https:\/\/doi.org\/10.1177\/10668969261489616","relation":{},"ISSN":["1066-8969","1940-2465"],"issn-type":[{"value":"1066-8969","type":"print"},{"value":"1940-2465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"10668969261489616"}}