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Pleomorphic xanthoastrocytomas (PXA) are rare, accounting for < 1% of all astrocytomas. Literature on the clinical course and treatment outcomes of PXAs is limited. The study aimed to determine prognosis and treatment strategies for PXAs. Patients who had PXAs surgery between 2000–2021 were retrospectively analyzed for demographics and radiological characteristics. Initial and salvage treatment outcomes were recorded. Overall, 40 and 9 patients had grade 2 and 3 PXAs; their 5-year progression-free survival (PFS) rates were 75.8% and 37.0%, respectively ( p  = 0.003). Univariate analysis revealed that strong T1 enhancement ( p  = 0.036), infiltrative tumor margins ( p  < 0.001), peritumoral edema ( p  = 0.003), WHO grade ( p  = 0.005), and gross total resection ( p  = 0.005) affected the PFS. Multivariate analysis revealed that the WHO grade ( p  = 0.010) and infiltrative tumor margins ( p  = 0.008) influenced the PFS. The WHO grade ( p  = 0.027) and infiltrative tumor margins ( p  = 0.027) also affected the overall survival (OS). Subgroup analysis for grade 2 PXAs revealed no significant associations between adjuvant radiation therapy and the PFS and OS. This study highlighted the heterogeneous nature of PXAs and its impact on patient prognosis. Infiltrative tumor margins emerged as a key prognostic factor. Our findings have emphasized the prognostic relevance of radiological features and the need for larger studies on comprehensive management.

Purpose Oligodendrogliomas (ODGs) are a subtype of diffuse lower-grade gliomas with overall survival of > 10 years. This study aims to analyze long-term outcomes and identify prognostic factors in patients with WHO grade 2 ODG. Methods We retrospectively reviewed 138 adult patients diagnosed with 1p/19q co-deleted ODG who underwent surgical resection or biopsy between 1994 and 2021, analyzing clinical data, treatment details, and outcomes. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier analysis. Univariate and multivariate Cox regression analyses were utilized to identify significant prognostic factors. Results In the gross total resection (GTR) group, 63 (45.7%) underwent observation and 5 (3.6%) received postoperative treatment; in the non-GTR group, 37 (26.8%) were observed and 33 (23.9%) received postoperative treatment. The median PFS and OS were 6.8 and 18.4 years, respectively. Between adjuvant treatment and observation, there was no significant difference in PFS or OS. However, GTR or STR with less than 10% residual tumor exhibited significantly better PFS and OS compared to PR or biopsy (p = 0.022 and 0.032, respectively). Multivariate analysis revealed that contrast enhancement on MRI was associated with worse PFS (HR = 2.36, p < 0.001) and OS (HR = 5.89, p = 0.001). And the presence of seizures at presentation was associated with improved OS (HR = 0.28, p = 0.006). Conclusion This study underscores favorable long-term outcomes for patients with 1p/19q co-deleted ODG WHO grade 2. Our findings indicate that the EOR plays a crucial role as a significant prognostic factor in enhancing PFS and OS outcomes in WHO grade 2 ODG.

This study aimed to reveal the clinical significance of the platelet reactivity unit (PRU) and the efficacy of adjunctive cilostazol and its association with thromboembolic and microembolic events after coil embolization for unruptured intracranial aneurysms (UIAs). We retrospectively analyzed the data of 427 patients with UIAs who underwent endovascular treatment between July 2011 and June 2014. When clopidogrel resistance was confirmed via PRU assay after dual antiplatelet medication (aspirin plus clopidogrel) administration for 5 days, triple antiplatelet therapy with cilostazol was administered (Group I, 274 patients). The other group was placed on standard dual antiplatelet therapy (Group II, 153 patients). All patients underwent magnetic resonance diffusion-weighted imaging within 2 days after endovascular coiling. No significant associations with the occurrence of thromboembolic and microembolic events were found between the groups. The occurrence of thromboembolic and microembolic events showed no statistical difference between groups I and II (p = 0.725 for thromboembolic events and p = 0.109 for microembolic events). Also, the PRU value and the occurrence of microembolic events, using a PRU cutoff value of 240, showed no statistical difference (p = 0.114 in group I and 0.064 in group II). There was significant increase in microembolic events after the use of a stent-assisted endovascular procedure. As the PRU value increased, there was a trend toward an increase in the mean number of microembolic lesions without statistical significance. Even though there is a presumed anti-thromboembolic effect for clopidogrel resistance in other literature, the clinical efficacy of adjustment of additional cilostazol for endovascular coiling of unruptured aneurysms may be limited due to the unspecified cutoff value of the PRU assay for evaluating the resistance. •PRU assays are not associated with thromboembolism during coil embolization.•The clinical effectiveness of PRU assays for clopidogrel resistance may be limited.•The efficacy of adjunctive cilostazole for clopidogrel resistant patients based on PRU assays may be limited.•There was a trend toward more thromboembolic numbers in the higher PRU values.

Background/Objectives: The management of primary central nervous system lymphoma (PCNSL) has traditionally prioritized diagnostic biopsy, with surgical resection often considered secondary due to risks and potential bias in previous studies, which included patients with deep or multiple tumors. This study aims to evaluate the impact of surgical resection on survival in patients with solitary, resectable PCNSL. Methods: We conducted a retrospective analysis of PCNSL patients treated via brain biopsy or surgical resection at our institution between January 2010 and December 2022. Cases with deep-located tumors (corpus callosum, basal ganglia, thalamus, and brainstem) or multiple lesions were excluded. Survival and clinical outcomes were compared between the two groups. Results: A total of 79 patients (30 resection and 49 biopsy) were included. No significant differences were observed between groups regarding demographics, comorbidities, tumor characteristics, or International Extranodal Lymphoma Study Group scores. Preoperative midline shifting (p = 0.048) and steroid use (p < 0.001) were higher in the resection group, which also demonstrated greater symptom improvement (p < 0.001). The complication rates were comparable between groups. The 5-year overall survival (OS) was 81.3% (resection) vs. 80.1% (biopsy), and the 5-year progression-free survival (PFS) was 53.6% (resection) vs. 60.3% (biopsy), with no significant differences in OS or PFS by Cox regression analysis. Conclusions: Surgical resection does not improve OS or PFS in solitary, resectable PCNSL, though it may provide symptomatic relief in select cases. Further prospective studies are needed to define its role in PCNSL management.

Key messageA non-synonymous SNP of CC–NBS–LRR was firstly mapped to confer resistance to anthracnose in watermelon. Newly proposed LRR domain harboring the SNP is evolutionary conserved in the Cucurbitaceae and Fabaceae.Anthracnose disease caused by Colletotrichum devastates many plants. Despite the importance of the disease, the mechanisms of resistance against it are poorly understood. Here, we identified a non-synonymous single-nucleotide polymorphism (SNP) located in a leucine-rich repeat domain as a marker for resistance to anthracnose race 1 in watermelon, using a combination of genetic analyses. We validated this SNP in segregating populations and 59 watermelon accessions using high-resolution melting assays and Sanger sequencing. We demonstrated that the resulting arginine-to-lysine substitution is particularly conserved among the Cucurbitaceae and Fabaceae. We identified a conserved motif, IxxLPxSxxxLYNLQTLxL, found in 1007 orthologues/paralogues from 89 plant species, and discovered that residue 18 of this motif could determine resistance to disease caused by external invaders. This study provides a step forward in understanding anthracnose resistance in watermelon, as well as functional and evolutionary insight into leucine-rich repeat proteins.