Effect of dural detachment on long-term tumor control for meningiomas treated using Simpson Grade IV resection

Fukushima, Yuta; Oya, Soichi; Nakatomi, Hirofumi; Shibahara, Junji; Hanakita, Shunya; Tanaka, Shota; Shin, Masahiro; Kawai, Kensuke; Fukayama, Masashi; Saito, Nobuhito

doi:10.3171/2013.8.jns13832

Cited by 23 publications

(17 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, tumor locating in skull base was confirmed as an independent risk factor for 3-year PFS in multivariate analysis. Fukushima et al reported that skull base location was independently associated with tumor recurrence in patients following Simpson Grade IV resection (41). Another study also validated the higher recurrence rate of skull base tumor in a Grade I-V cohort (42).…”

Section: Discussionmentioning

confidence: 85%

A Novel Scoring System Based on Preoperative Routine Blood Test in Predicting Prognosis of Atypical Meningioma

Wang

Zhang

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

The aim of this study was to explore the correlation and clinical significance of preoperative fibrinogen and neutrophil-lymphocyte ratio (F-NLR) scoring system with 3-year progression-free survival (PFS) of patients with atypical meningioma. Materials and Methods: Clinical, pathological, radiological, and laboratory variables were collected to analyze their correlation with 3-year PFS in the training set with 163 patients. Patients were classified by different F-NLR scores (0, 1, or 2). External validation for the predictive value of F-NLR scoring system was performed in the validation set with 105 patients. Results: Overall, 37.3% (100 of 268) of the enrolled patients were male. The scoring system showed good performance in predicting 3-year PFS (AUC = 0.872, 95%CI = 0.811-0.919, sensitivity = 66.1%, specificity = 93.3%, and Youden index = 0.594). DeLong's test indicated that the AUC of F-NLR scoring system was significantly greater than that of fibrinogen level and NLR (Z = 2.929, P = 0.003; Z = 3.376, P < 0.001). Multivariate Cox analysis revealed that tumor size (HR = 1.39, 95%CI = 1.10-1.76, P = 0.007), tumor location (HR = 3.11, 95%CI = 1.60-6.95, P = 0.001), and F-NLR score (score of 1: HR = 12.78, 95%CI = 3.78-43.08, P < 0.001; score of 2: HR = 44.58, 95%CI = 13.02-152.65, P < 0.001) remained significantly associated with 3-year PFS. The good predictive performance of F-NLR scoring system was also demonstrated in the validation set (AUC = 0.824, 95%CI = 0.738-0.891, sensitivity = 62.5%, specificity = 87.9%, and Youden index = 0.504). Conclusion: Our study confirmed the correlation and clinical significance of preoperative F-NLR scoring system with 3-year PFS of patients with atypical meningioma. A prospective and large-scale study is required to validate our findings.

show abstract

Section: Discussionmentioning

confidence: 85%

A Novel Scoring System Based on Preoperative Routine Blood Test in Predicting Prognosis of Atypical Meningioma

Wang

Zhang

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…However, mass removal and generous coagulation of the dural attachment are highly recommended even in Simpson grade IV resection, because dural detachment is important to prevent recurrence in cases of Simpson grade IV removal in patients with intracranial meningiomas. 12) …”

Section: Discussionmentioning

confidence: 99%

Is Simpson Grade I Removal Necessary in All Cases of Spinal Meningioma? Assessment of Postoperative Recurrence during Long-Term Follow-up

Tsuda

Akutsu

Yamamoto

et al. 2014

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

It is generally accepted that the first choice of treatment for spinal meningiomas is "radical" surgical removal. However, Simpson grade I removal is sometimes difficult, especially in cases with ventral dural attachment, because of the risk of spinal cord damage or the difficulty of dural repair after radical resection. In addition, there is no consensus on a surgical strategy for radicality, whether or not Simpson grade I resection should be performed in all cases of spinal meningioma. In this study, we retrospectively analyzed clinical and radiological data of surgically treated 14 patients with spinal meningioma, to assess the influence of the Simpson grade to tumor recurrences during long-term follow-up (median 8.2 years, 1.3-27.9). The number of patients in Simpson grades I, II, III, and IV were 2, 8, 0, and 3, respectively; Simpson grading was not applicable to one patient with non-dura-based meningioma. No postoperative permanent neurological worsening was encountered. The recurrence rate was 21.4% (3 out of 14 cases). Of these 3 recurrent cases, 1 was a case of non-dura-based meningioma and another was a case of neurofibromatosis type 2 (NF2); both of them are known as risk factors for recurrence after surgical removal of spinal meningiomas. Considering this background of these two recurrences, the clinical results of the present study are consistent with previous results. Therefore, we propose that surgeons do not always have to achieve Simpson grade I removal if dural repair is complicated and postoperative cerebrospinal fluid (CSF) leakage or neurological worsening are estimated after resection of dural attachment and repair of dural defect.

show abstract

“…Fukushima et al examined a series of grade IV meningiomas and showed that a volume of residual tumor > 4 cm 3 predicted recurrence on univariate analysis. 19 Materi et al posed a similar question and used postoperative volumetric MRI to examine patients with Simpson grade IV resections. 20 The authors reported that residual volume > 5 cm 3 was associated with increased growth rate.…”

Section: Simpson Grade IVmentioning

confidence: 99%

The Simpson grade: abandon the scale but preserve the message

Schwartz

McDermott

2021

Journal of Neurosurgery

View full text Add to dashboard Cite

The Simpson grading scale, developed in 1957 by Donald Simpson, has been considered the gold standard for defining the surgical extent of resection for WHO grade I meningiomas. Since its introduction, the scale and its modifications have generated enormous controversy. The Simpson grade is based on an intraoperative visual assessment of resection, which is subjective and notoriously inaccurate. The majority of studies in which the grading system was used were performed before routine postoperative MRI surveillance was employed, rendering assessments of extent of resection and the definition of recurrence inconsistent. The infiltration and proliferation potential of tumor components such as hyperostotic bone and dural tail vary widely based on tumor location, as does the molecular biology of the tumor, rendering a universal scale for all meningiomas unfeasible. While extent of resection is clearly important at reducing recurrence rates, achieving the highest Simpson grade resection should not always be the goal of surgery.Donald Simpson’s name and his scale deserve to be recognized and preserved in the historical pantheon of pioneering and transformative neurosurgical concepts. Nevertheless, his eponymous scale is no longer relevant in modern meningioma surgery. While his message of maximizing extent of resection and minimizing morbidity is still germane, a single measure using subjective criteria cannot be applied universally to all meningiomas, regardless of location. Meningioma surgery should be performed with the goal of achieving maximal safe resection, ideally guided by molecularly tagged fluorescent labeling and assessed using objective criteria, including postoperative MRI as well as molecularly tagged scans such as [68Ga]-DOTATATE-PET.

show abstract

Effect of dural detachment on long-term tumor control for meningiomas treated using Simpson Grade IV resection

Cited by 23 publications

References 34 publications

A Novel Scoring System Based on Preoperative Routine Blood Test in Predicting Prognosis of Atypical Meningioma

A Novel Scoring System Based on Preoperative Routine Blood Test in Predicting Prognosis of Atypical Meningioma

Is Simpson Grade I Removal Necessary in All Cases of Spinal Meningioma? Assessment of Postoperative Recurrence during Long-Term Follow-up

The Simpson grade: abandon the scale but preserve the message

Contact Info

Product

Resources

About