Natural history of meningiomas: a serial volumetric analysis of 240 tumors

Abstract

OBJECTIVE The management of asymptomatic intracranial meningiomas is controversial. Through the assessment of growth predictors, the authors aimed to create the basis for practicable clinical pathways for the management of these tumors. METHODS The authors volumetrically analyzed meningiomas radiologically diagnosed at their institution between 2003 and 2015. The primary endpoint was growth of tumor volume. The authors used significant variables from the multivariable regression model to construct a decision tree based on the exhaustive Chi-Square Automatic Interaction Detection (CHAID) algorithm. RESULTS Of 240 meningiomas, 159 (66.3%) demonstrated growth during a mean observation period of 46.9 months. On multivariable logistic regression analysis, older age (OR 0.979 [95% CI 0.958–1.000], p = 0.048) and presence of calcification (OR 0.442 [95% CI 0.224–0.872], p = 0.019) had a negative predictive value for tumor growth, while T2-signal iso-/hyperintensity (OR 4.415 [95% CI 2.056–9.479], p < 0.001) had a positive predictive value. A decision tree model yielded three growth risk groups based on T2 signal intensity and presence of calcifications. The median tumor volume doubling time (Td) was 185.7 months in the low-risk, 100.1 months in the intermediate-risk, and 51.7 months in the high-risk group (p < 0.001). Whereas 0% of meningiomas in the low- and intermediate-risk groups had a Td of ≤ 12 months, the percentage was 8.9% in the high-risk group (p = 0.021). CONCLUSIONS Most meningiomas demonstrated growth during follow-up. The absence of calcifications and iso-/hyperintensity on T2-weighted imaging offer a practical way of stratifying meningiomas as low, intermediate, or high risk. Small tumors in the low- or intermediate-risk categories can be monitored with longer follow-up intervals.

Gamma knife radiosurgery as primary management for intracranial meningioma identified as growing on serial imaging

“…[12] During active surveillance, size growing has been observed in 24% to 70% of incidental meningioma. [3,4,12,13] There is lack of comprehensive evidence regarding treatment strategies for this frequently encountered growing meningioma. Surgical resection is the primary approach in managing meningiomas.…”

Induced senescence and calcification in anaplastic meningioma

“…Meningiomas are brain tumors that account for one-third of all CNS tumors, arise from arachnoid cells tightly adherent to the dura [1,2], and affect the surrounding bone in 25-50% of cases, causing bone changes such as hyperostosis and ballooning [1,2]. Calci cation can also occur within the tumor, and tumors with calci cation often do not enlarge [3]. Malignant atypical meningiomas and anaplastic meningiomas frequently recur and exhibit aggressive behavior with or without bone destruction [4], resulting in 5-year survival rates of 67.5% for atypical meningioma and 55.6% for anaplastic meningioma.…”

Inpatient satisfaction survey based on national standard satisfaction questionnaire conducted in a tertiary hospital in Shenyang, China

“…Firstly, CHAID is particularly effective in addressing typical classi cation issues like satisfaction [12]. Secondly, it offers a step-by-step construction of a classi cation pattern, providing a clear and interpretable understanding of inter-factor relationships [13]. This method bridges the gaps between identifying factors and explaining their relationships, thereby assisting managers in policy-making.…”