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Here, we evaluated the effect of this new classification in the stratification of gliomas previously diagnosed according to 2007 WHO classification. Then, we also analyzed the impact of <jats:italic>TERT<\/jats:italic> promoter mutations, <jats:italic>PTEN<\/jats:italic> deletion, <jats:italic>EGFR<\/jats:italic> amplification and <jats:italic>MGMT<\/jats:italic> promoter methylation in diagnosis, prognosis and response to therapy in glioma molecular subgroup.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cohort of 444 adult gliomas was analyzed and reclassified according to the 2016 WHO. Mutational analysis of <jats:italic>IDH1<\/jats:italic> and <jats:italic>TERT<\/jats:italic> promoter mutations was performed by Sanger sequencing. Statistical analysis was done using SPSS Statistics 21.0.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The reclassification of this cohort using 2016 WHO criteria led to a decrease of the number of oligodendrogliomas (from 82 to 49) and an increase of astrocytomas (from 49 to 98), while glioblastomas (GBM) remained the same (<jats:italic>n<\/jats:italic>\u2009=\u2009256). GBM was the most common diagnosis (57.7%), of which 55.2% were <jats:italic>IDH-<\/jats:italic>wildtype. 1p\/19q codeleted gliomas were the subgroup associated with longer median overall survival (198\u2009months), while GBM <jats:italic>IDH-<\/jats:italic>wildtype had the worst outcome (10\u2009months). Interestingly, <jats:italic>PTEN<\/jats:italic> deletion had poor prognostic value in astrocytomas <jats:italic>IDH-<\/jats:italic>wildtype (<jats:italic>p<\/jats:italic>\u2009=\u20090.015), while in GBM <jats:italic>IDH-<\/jats:italic>wildtype was associated with better overall survival (<jats:italic>p<\/jats:italic>\u2009=\u20090.042) as well as <jats:italic>MGMT<\/jats:italic> promoter methylation (<jats:italic>p<\/jats:italic>\u2009=\u20090.009). <jats:italic>EGFR<\/jats:italic> amplification and <jats:italic>TERT<\/jats:italic> mutations had no impact in prognosis. Notably, <jats:italic>EGFR<\/jats:italic> amplification predicted a better response to radiotherapy (<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and <jats:italic>MGMT<\/jats:italic> methylation to chemo-radiotherapy (<jats:italic>p<\/jats:italic>\u2009=\u20090.003).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this study we observed that the 2016 WHO classification improved the accuracy of diagnosis and prognosis of diffuse gliomas, although the available biomarkers are not enough. Therefore, we suggest <jats:italic>MGMT<\/jats:italic> promoter methylation should be added to glioma classification. Moreover, we found two genetic\/clinical correlations that must be evaluated to understand their impact in the clinical setting: i) how is <jats:italic>PTEN<\/jats:italic> deletion a favorable prognostic factor in GBM <jats:italic>IDH<\/jats:italic> wildtype and an unfavorable prognostic factor in astrocytoma <jats:italic>IDH<\/jats:italic> wildtype and ii) how <jats:italic>EGFR<\/jats:italic> amplification is an independent and strong factor of response to radiotherapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-019-6177-0","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T14:59:24Z","timestamp":1571324364000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Clinical insights gained by refining the 2016 WHO classification of diffuse gliomas with: EGFR amplification, TERT mutations, PTEN deletion and MGMT methylation"],"prefix":"10.1186","volume":"19","author":[{"given":"Cheila","family":"Brito","sequence":"first","affiliation":[]},{"given":"Ana","family":"Azevedo","sequence":"additional","affiliation":[]},{"given":"Susana","family":"Esteves","sequence":"additional","affiliation":[]},{"given":"Ana Rita","family":"Marques","sequence":"additional","affiliation":[]},{"given":"Carmo","family":"Martins","sequence":"additional","affiliation":[]},{"given":"Ilda","family":"Costa","sequence":"additional","affiliation":[]},{"given":"Manuela","family":"Mafra","sequence":"additional","affiliation":[]},{"given":"Jos\u00e9 M.","family":"Bravo Marques","sequence":"additional","affiliation":[]},{"given":"L\u00facia","family":"Roque","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4036-6731","authenticated-orcid":false,"given":"Marta","family":"Pojo","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,10,17]]},"reference":[{"issue":"7","key":"6177_CR1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1093\/neuonc\/nou087","volume":"16","author":"QT Ostrom","year":"2014","unstructured":"Ostrom QT, Bauchet L, Davis FG, Deltour I, Fisher JL, Langer CE, et al. 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