Risk factors associated with postoperative recurrence in atypical intracranial meningioma: analysis of 263 cases at a single neurosurgical centre

Wang, Fang; Xu, Dingkang; Liu, Yumeilan; Lin, Yu Cheng; Wei, Qi; Gao, Qiang; Lei, Shixiong; Guo, Fuyou

doi:10.1007/s00701-019-04073-2

Cited by 28 publications

(25 citation statements)

References 30 publications

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“…Zaher et al reported that age (<50 years) and total surgical excision were independent prognostic factors for survival and radiotherapy could reduce the postoperative recurrence (5). There is evidence showing that age, male gender, extent of surgical resection, and higher MIB-1 (a commonly used monoclonal antibody that detects the Ki-67 antigen) labeling index influence the prognosis of AM patients, and postoperative radiotherapy fails to provide long-term tumor control (6,7). In a Korea study, results showed the overall survival was not related to the patient age, gender, tumor location, Ki-67 (a cellular marker for proliferation), Simpson grade, and treatment (8).…”

Section: Introductionmentioning

confidence: 99%

Factors Related to the Post-operative Recurrence of Atypical Meningiomas

Tang

Yang

et al. 2020

Front. Oncol.

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Aim: This study aimed to investigate the relationship between clinicopathological characteristics of atypical meningiomas (AM) and its post-operative recurrence. Materials and Methods:The clinicopathological characteristics and findings from follow up were retrospectively reviewed and compared between AM and benign meningioma (BM) patients. Univariate and multivariate analyses were employed to identify the factors related to the post-operative recurrence of AM.Results: More BM patients were females and received complete resection; the recurrence rate was significantly lower in BM patients as compared to AM patients. The progesterone receptor (PR), E-cadherin protein (E-Ca) and β-catenin positive rates and Ki67 labeling index were significantly different between two groups. Univariate analysis showed the age, tumor size, tumor invasiveness, E-Ca expression, and extent of resection were related to the post-operative recurrence of AM. However, multivariate analysis showed only the extent of resection and tumor invasiveness were the independent factors associated with the post-operative recurrence of AM. Conclusions:The extent of resection and tumor invasiveness are related to the postoperative recurrence of AM. To improve the surgical procedures to maximize the tumor resection is important to improve the prognosis of AM patients.

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Section: Introductionmentioning

confidence: 99%

Factors Related to the Post-operative Recurrence of Atypical Meningiomas

Tang

Yang

et al. 2020

Front. Oncol.

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“…Whether atypical meningiomas patients need postoperative radiation therapy, remains controversial. Some studies showed that there was no signi cant bene t for progression-free survival or overall survival after adjuvant radiotherapy for atypical meningiomas [23][24][25]. Compared with benign meningioma, atypical meningioma is a tumor with a relatively poor prognosis and with a recurrence rate of approximatively 29%-52% [22].The main recurrence factors that affect are related to the extent of the surgical resection, the tumor site and invasion extent, the vital adjacent structure of the tumor and the surgeon skills [22,25].…”

Section: Discussionmentioning

confidence: 99%

Atypical Meningioma in the Medulla Oblongata Parenchyma

Pan

Hou

et al. 2020

Preprint

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Background: Glioma is the most common tumor occurring in the brainstem. A primary intraparenchymal meningioma located in the brainstem without dura attachment is rare. Meanwhile, atypical meningiomas that occur in the medulla oblongata parenchyma, and without dura coverage, are extremely rare. In this study, we report the first case of atypical meningioma in the medulla oblongata parenchyma and review the existing literature.Case presentation: A 38-year-old female was admitted at our hospital with a 2-week history of progressive neck and occipital pain. Magnetic resonance imaging revealed a presence of a 1.5x0.9cm mass lesion, located in the left side of the medulla oblongata, which was hypointense on T1-weighted and hyperintense on T2-weighted images, and with inhomogeneous enhancement following gadolinium-diethylenet-riamine pentaacetic acid (Gd-DTPA) administration. The initial preoperative diagnosis was glioma or angioblastoma. The patient underwent a total surgical resection of the left medulla oblongata tumor and the histopathological examination indicated that the lesion was an atypical meningioma. The patient returned to normal life after surgery.Conclusions: Although glioma is the most common tumor occurring in the brainstem parenchyma, the possibility of meningioma cannot be ruled out in this area.

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“…In previous study with a large sample size, adjuvant radiotherapy was not a prognostic factor for survival in the overall population (P=0.187), but for patients with subtotal resection, adjuvant radiotherapy significantly improved OS (P=0.026) (25). Wang et al showed a lower recurrence rate for patients treated with subtotal resection followed by adjuvant radiotherapy (P=0.023) (26). In a recent study with a large sample size, adjuvant radiotherapy improved OS regardless of the extent of surgery.…”

Section: Adjuvant Radiotherapymentioning

confidence: 95%

High risk of recurrence for grade II meningioma: a 10-year multicenter analysis of prognosis factors

Bender¹,

Somme²,

Lhermitte³

et al. 2021

Chin Clin Oncol

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Background: Atypical meningioma is a variant of meningioma with a high risk of recurrence. Gross total resection is the standard of treatment, while no consensus on optimal adjuvant management has been found. Methods: Between 2008 and 2018, a retrospective search identified 216 grade II meningiomas treated in six centers. Clinical, histological, and therapeutic data were analyzed to determine the prognostic factors of recurrence and survival. Results: In total, 216 patients underwent surgical resection. Among these, 122 patients (56%) underwent gross total resection, and 21% of the patients received adjuvant radiotherapy. Univariate analysis reported subtotal resection, high Ki-67, negative progesterone receptor (PR) and histological grade evolution as unfavorable prognosis factors. According to multivariate analysis, the Ki-67 proliferative index (cut-off value of 17.5%) was the only prognostic factor of recurrence (HR 1.1; 95% CI, 1.0-1.2, P=0.048). Gross total resection improved progression-free survival (PFS) (P=0.03) but without impact on overall survival (OS) (P=0.2). Median PFS and OS times were longer for patients receiving adjuvant radiotherapy than those who did not receive adjuvant radiotherapy. PFS (P=0.3) and OS (P=0.7) were associated with adjuvant RT by trend only. After a median follow-up time of 6.7 years, 99 (46%) patients relapsed. Median progression-free and OS rates were 4.5 (95% CI, 3.5-5.5) and 14.7 years (11.4-NA), respectively. Conclusions: In this study, Ki-67 proliferative index was significantly associated with recurrence. Gross total resection significantly improved PFS without impacting OS. Adjuvant radiotherapy delayed recurrence and improved OS, but a longer follow-up time is needed to distinguish a statistically significant difference. Large prospective studies are needed to determine postoperative treatment guidelines.

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Risk factors associated with postoperative recurrence in atypical intracranial meningioma: analysis of 263 cases at a single neurosurgical centre

Cited by 28 publications

References 30 publications

Factors Related to the Post-operative Recurrence of Atypical Meningiomas

Factors Related to the Post-operative Recurrence of Atypical Meningiomas

Atypical Meningioma in the Medulla Oblongata Parenchyma

High risk of recurrence for grade II meningioma: a 10-year multicenter analysis of prognosis factors

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