Clinical Outcome, Tumor Recurrence, and Causes of Death: A Long-Term Follow-Up of Surgically Treated Meningiomas

Almeida, Antônio Nogueira de; Pereira, Benedito Jamilson Araújo; Aguiar, Paulo Henrique Pires de; Paiva, Wellingson Silva; Cabrera, Hector Navarro; Silva, Clemar Corrêa da; Teixeira, Manoel Jacobsen; Marie, Suely Kazue Nagahashi

doi:10.1016/j.wneu.2017.03.009

Cited by 36 publications

(14 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In general, higher WHO grading has been associated with the poor prognosis of meningiomas [30]. According to a previous analysis of primary SBMs, 16 of 358 patients had WHO grade II meningiomas [10].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcome of First Recurrence Skull Base Meningiomas

Kuranari

Tamura

Tsuda

et al. 2019

JCM

View full text Add to dashboard Cite

Skull base meningiomas (SBMs) are considered to be less aggressive and have a slower growth rate than non-SBMs. However, SBMs often develop local recurrences after surgical resection. Gross total removal is difficult because SBMs are deep-seated tumors and involve critical neurovascular structures. The treatment strategy for recurrent SBMs remains controversial. The present study aimed to evaluate the long-term clinical course and prognostic factors associated with shorter progression-free survival (PFS) of recurrent SBMs. This retrospective study included 85 recurrent SBMs from 65 patients who underwent surgery from January 2005 to September 2018. Overall survival (OS) and PFS were evaluated, and the associations among shorter PFS and age, sex, tumor size, lesions, World Health Organization (WHO) grading, removal rate, and time since prior surgery were analyzed. The median follow-up period for PFS was 68 months. The 2-, 5-, and 10-year PFS rates were 68.0%, 52.8%, and 22.7%, respectively. WHO grade II or III, multiple lesions, and tumor size were significantly associated with shorter PFS (p < 0.0001, p = 0.030, and p = 0.173, respectively). Although, radiotherapy did not improve PFS and OS for overall patients, PFS of the patients with subtotal and partial removal for WHO grade II SBMs was significantly improved by the radiotherapy. Multivariate analysis identified WHO grade II or III and multiple lesions as independent prognostic factors for shorter PFS (p < 0.0001 and p = 0.040, respectively). It is essential to estimate the risks associated with shorter PFS for patients with recurrent SBMs to aid in the development of appropriate postoperative strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcome of First Recurrence Skull Base Meningiomas

Kuranari

Tamura

Tsuda

et al. 2019

JCM

View full text Add to dashboard Cite

show abstract

“…However, better prognosis of skull base and optic nerve sheath meningiomas in our study appears contrary to other publications. Convexity meningiomas were reported to perform better than skull base (or generally other) meningiomas due to superior surgical accessibility [16, 18]. This previously proposed prognostic influence of the localization might have been partly overcome by recent surgical techniques or changes in management by elected partial, maximal-safe resections and adjuvant radiotherapy [2].…”

Section: Discussionmentioning

confidence: 99%

Integrative assessment of brain and bone invasion in meningioma patients

et al. 2019

View full text Add to dashboard Cite

Background Various prognostic factors have been suggested in meningioma patients including WHO grading, brain invasion and bone involvement, for instance. Brain invasion was included as an independent criterion in the recent WHO classification. However, assessability of brain or bone involvement is often limited or varies between histopathologic, operative and imaging reports. Objective of our study was to investigate prognostic values including brain and bone involvement according to different clinical approaches. Methods A cohort of 111 patients was treated with primary, adjuvant or salvage irradiation between 2008 and 2017 using intensity-modulated radiotherapy. Positron-emission tomography (PET) was available for treatment planning in 81% of patients. Clinical data were extracted from the medical reports. Brain and bone involvement were stratified separately according to histopathologic, operative and imaging reports as well as judged in synopsis. Results WHO grade I tumours, lower estimated proliferation index, primary versus recurrence treatment and localization (i.e. skull base, optic nerve sheath) were beneficial prognostic factors for local control. Judgement of brain and bone invasion partly differed between diagnostic modalities. In synopsis, brain or bone invasion did not show a significant influence on local control rates. Conclusions Several previously described prognostic factors could be reproduced. However, partly divergent histopathological, surgical and image-based judgements could be found in regard to brain and bone invasion and all methods imply limitations. Therefore, we suggest a particular, complemental synopsis judgement. In synopsis, brain or bone involvement did not coherently impair local control in our irradiated patients. This might be explained by elaborate radiation techniques and PET-based treatment planning. Electronic supplementary material The online version of this article (10.1186/s13014-019-1341-x) contains supplementary material, which is available to authorized users.

show abstract

“…7,8 In human patients with meningioma, GTR resulted in a decrease in the rate of recurrence 29 and prolonged survival. 30 The intraoperative use of FS may assist in the resection of homogeneously stained brain tumors in dogs, leading to improved rates of GTR and, hence, long-term survival; however, additional studies are required to confirm this.…”

Section: Discussionmentioning

confidence: 99%