Cohort-level proportions of low-grade glioma (WHO grades I-II) in mixed glioma cohorts: a single-arm meta-analysis for epidemiological benchmarking and clinical trial design.
- 1Department of Radiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Abstract
Background
Mixed-grade glioma surgical cohorts exhibit highly variable low-grade glioma (LGG) proportions across studies. This meta-analysis quantifies pooled LGG proportions to provide cohort-level epidemiological benchmarks for researchers, with applications in clinical trial design, health economics, and institutional benchmarking.Methods
A single-arm meta-analysis of 191 cohort studies (25,847 patients) with Grade II numerators and denominators from Embase, MEDLINE, PubMed, and Scopus (PRISMA 2020) used Freeman-Tukey random-effects synthesis with Cochrane risk-of-bias assessments; subgroup analyses examined study design, geography, era, molecular specificity, and interventions; sensitivity analyses tested robustness.Results
The pooled LGG proportion was 57% (95% CI: 52%-61%; I²=99%; n=191). Mixed LGG/high-grade gliomas (HGG) cohorts showed 41% (32%-50%; 45 studies, 6,847 patients) versus 82% (77%-88%) in pure WHO Grade II cohorts (25 studies). Surgery-only cohorts demonstrated 46% (33%-59%) versus 86% (74%-98%) with targeted therapies, and 93% (90%-96%) in randomized controlled trials. Sensitivity analyses confirmed stability (50%-62%).Conclusion
In mixed-grade glioma cohorts, an LGG proportion approaching 60% may serve as a cohort-level epidemiological reference for understanding the historical grade composition of mixed surgical series. This meta-analysis primary value lies in applications such as clinical trial design, health economics and epidemiological modeling, and institutional benchmarking.Systematic review registration
https://www.crd.york.ac.uk/prospero/, identifier CRD420261323907.
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BibTeX
@article{zhang2026cohortlevel,
title = {{Cohort-level proportions of low-grade glioma (WHO grades I-II) in mixed glioma cohorts: a single-arm meta-analysis for epidemiological benchmarking and clinical trial design.}},
author = {Shenao Zhang and Yawen Zheng and Yinjiao Wang and Lang Chen and Tianjun Song and Haiyan Zhang and Aihong Cao and Peng Du},
journal = {Frontiers in oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1888445},
url = {https://europepmc.org/article/MED/42908559},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cohort-level proportions of low-grade glioma (WHO grades I-II) in mixed glioma cohorts: a single-arm meta-analysis for epidemiological benchmarking and clinical trial design.
AU - Shenao Zhang
AU - Yawen Zheng
AU - Yinjiao Wang
AU - Lang Chen
AU - Tianjun Song
AU - Haiyan Zhang
AU - Aihong Cao
AU - Peng Du
PY - 2026
DA - 2026/10/07
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1888445
UR - https://europepmc.org/article/MED/42908559
AB - Background Mixed-grade glioma surgical cohorts exhibit highly variable low-grade glioma (LGG) proportions across studies. This meta-analysis quantifies pooled LGG proportions to provide cohort-level epidemiological benchmarks for researchers, with applications in clinical trial design, health economics, and institutional benchmarking.Methods A single-arm meta-analysis of 191 cohort studies (25,847 patients) with Grade II numerators and denominators from Embase, MEDLINE, PubMed, and Scopus (PRISMA 2020) used Freeman-Tukey random-effects synthesis with Cochrane risk-of-bias assessments; subgroup analyses examined study design, geography, era, molecular specificity, and interventions; sensitivity analyses tested robustness.Results The pooled LGG proportion was 57% (95% CI: 52%-61%; I²=99%; n=191). Mixed LGG/high-grade gliomas (HGG) cohorts showed 41% (32%-50%; 45 studies, 6,847 patients) versus 82% (77%-88%) in pure WHO Grade II cohorts (25 studies). Surgery-only cohorts demonstrated 46% (33%-59%) versus 86% (74%-98%) with targeted therapies, and 93% (90%-96%) in randomized controlled trials. Sensitivity analyses confirmed stability (50%-62%).Conclusion In mixed-grade glioma cohorts, an LGG proportion approaching 60% may serve as a cohort-level epidemiological reference for understanding the historical grade composition of mixed surgical series. This meta-analysis primary value lies in applications such as clinical trial design, health economics and epidemiological modeling, and institutional benchmarking.Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD420261323907.
SN - 2234-943X
ER -