Tumor recurrence in parasagittal and falcine atypical meningiomas invading the superior sagittal sinus

Cucu, Andrei; Turliuc, Mihaela Dana; Costea, Claudia Florida; Dascălu, Cristina Gena; Dumitrescu, Gabriela; Sava, Anca; Turliuc, Şerban; Scripcariu, Dragoş Viorel; Poeată, I.

doi:10.47162/rjme.61.2.08

Cited by 12 publications

(15 citation statements)

References 91 publications

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“…Meanwhile, postoperative PTE fadeaway within 3 months after operation demonstrated complex and different mechanisms of preoperative PTE such as venous compression, expression of VEGF or rich blood supply and a lower rate of tumor cell invading brain tissue. We also found tumor located in superior sagittal sinus were one of the risk factors associated with tumor recurrence which is similar to previous research [31][32][33]. In this region in which venous lakes and large con uent veins are commonly found, which means tumor with superior sagittal sinus invasion may compress the vein causing PTE.…”

Section: Discussionsupporting

confidence: 90%

Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

Ying

Dong

et al. 2023

Preprint

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Purpose Peritumoral edema (PTE) in intracranial meningiomas correlates to surgical outcomes. But only depending on preoperative PTE in meningioma does not accurately predict the prognosis after resection. We aimed to investigate whether postoperative PTE could improve the prognosis prediction of meningioma patients with preoperative PTE. Methods We retrospectively reviewed postoperative MRI scans in 3 months after operation of 371 patients with preoperative PTE of meningioma that underwent surgery between 2015 and 2017. All the patients were classified into two different groups according to whether had postoperative PTE fadeaway within 3 months after operation. Clinical manifestations, histopathology characteristics, radiology data and follow-up outcomes were noted. T-tests and chi-square tests were used to compare clinical characteristics. Univariate and multivariate Cox analysis and Kaplan‒Meier method were utilized to screen for clinical prognostic factors. Result Kaplan-Meier model showed that the progression-free survival of patients with postoperative PTE are shorter than who with postoperative PTE fadeaway in 3 months after operation (HR = 3.30 ,P = 0.006). Multivariate Cox analyses showed that the predictors for recurrence of meningioma with preoperative: high WHO grades (HR = 4.989, P＜0.001), superior sagittal sinus invasion (HR = 2.290, P = 0.047), postoperative PTE in 3 months after operation (HR = 1.804, P = 0.044) and subtotal resection (HR = 3.940, P = 0.003). Conclusion According to our research, we found that postoperative PTE in 3 months after operation can predict the outcomes of patients of meningioma with preoperative PTE. Besides, we demonstrated that there were also some predictors for recurrence: male, high WHO grades, superior sagittal sinus invasion and subtotal resection.

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Section: Discussionsupporting

confidence: 90%

Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

Ying

Dong

et al. 2023

Preprint

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“…As reported by Mantovani and Mohammed et al., the parasagittal meningioma subgroup accounts for 19.5%–45% of all intracranial meningiomas 24,25 . Further, parasagittal and falcine meningiomas are the second most frequently occurring intracranial meningiomas 6 …”

Section: Discussionmentioning

confidence: 86%

“…24,25 falcine meningiomas are the second most frequently occurring intracranial meningiomas. 6 Some studies have reported prediction of grading, differential diagnosis, and prognosis of meningiomas using radiomic signatures (e.g., T1C, T2, DWI, T1WI, T1C, and ADC mapping). 8,[26][27][28] Hence, we explored the radiomic signatures associated with meningioma sinus invasion.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical strategy chosen may also vary for different types of sinus meningiomas and further determine the patient's postoperative treatment and prognosis 5 . Although maximum safe resection is the main treatment modality for sinus meningiomas, many postoperative complications can still occur 6,7 . The prognoses of venous sinus invasion and meningioma are closely related; for example, extensive resection in the sagittal region during sinus invasion of meningiomas leads to impaired venous outflow and results in high disability and mortality rates 8 .…”

Section: Introductionmentioning

confidence: 99%

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A radiomics model enables prediction venous sinus invasion in meningioma

Wang

Cao

Zhang

et al. 2023

Ann Clin Transl Neurol

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ObjectivePreoperative prediction of meningioma venous sinus invasion would facilitate the selection of surgical approaches and predicting the prognosis. To predict venous sinus invasion in meningiomas, we used radiomic signatures to construct a model based on preoperative contrast‐enhanced T1‐weighted (T1C) and T2‐weighted (T2) magnetic resonance imaging.MethodsIn total, 599 patients with pathologically confirmed meningioma were retrospectively enrolled. For each patient enrolled in this study, 1595 radiomic signatures were extracted from T1C and T2 image sequences. Pearson correlation analysis and recursive feature elimination were used to select the most relevant signatures extracted from different image sequences, and logistic regression algorithms were used to build a radiomic model for risk prediction of meningioma sinus invasion. Furthermore, a nomogram was built by incorporating clinical characteristics and radiomic signatures, and a decision curve analysis was used to evaluate the clinical utility of the nomogram.ResultsTwenty radiomic signatures that were significantly related to venous sinus invasion were screened from 3190 radiomic signatures. Venous sinus invasion was associated with tumor position, and the clinicoradiomic model that incorporated the above characteristics (20 radiomic signatures and tumor position) had the best discriminating ability. The areas under the curve for the training and validation cohorts were 0.857 (95% confidence interval [CI], 0.824–0.890) and 0.824 (95% CI, 0.752–0.8976), respectively.InterpretationThe clinicoradiomic model had good predictive performance for venous sinus invasion in meningioma, which can aid in devising surgical strategies and predicting prognosis.

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“…Although maximal resection of the adjacent bone is preferred [ 37 ], this can be challenging due to anatomical circumstances, such as extensive involvement of the skull base, infiltration of dural sinuses, or envelopment of arteries, cranial nerves, or muscle [ 38 , 39 , 40 , 41 , 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and prognostic factors of atypical meningiomas with bone invasion: a retrospective analysis of nine cases and literature review

Cucu,

Costea,

Macovei

et al. 2024

Rom J Morphol Embryol

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Background: Meningiomas are the most common primary neoplasms of the central nervous system in adults, arising from the arachnoid cap cells. Thus, grade 2 meningiomas are situated on the border between benignity and malignancy. Among the many prognostic factors that have been investigated in these tumors, bone invasion is one of them. Objective: The aim of our study was to identify whether bone invasion influences tumor recurrence and progression-free survival (PFS) in patients with atypical meningiomas (AMs). Patients, Materials and Methods: Out of 81 patients with AMs followed over a period of five years, we identified nine patients with bone invasion. We analyzed their demographic, clinical, imaging, and pathological characteristics, such as age, gender, radiological aspects, morphological features, extent of resection, recurrence rate, and PFS over a follow-up period of 60 months. Bone invasion was determined based on preoperative, surgical, and pathological reports. Results: Out of the nine patients with bone invasion, four had convexity meningiomas, four had parasagittal meningiomas and one had a falcine meningioma. Regarding tumor recurrence/progression, most patients (n=6) recurred within the first 24 months after surgery. Our study showed that the early recurrence/progression of tumor (at 12 months) correlated with extensive presence of malignancy criteria, especially with the presence of 15–18 mitoses/10 high-power fields, as well as with large foci of spontaneous necrosis, but also with tumor bone infiltration, extensive bone lamellae destruction, and tumor infiltration of adjacent muscle with its atrophy due to tumor compression. Patients with bone invasion had a PFS of 29.3 months, compared to patients without invasion who had a higher PFS (49.3 months). Significant statistical associations were observed between bone invasion and tumor recurrence (p=0.002) and PFS (p=0.004). Conclusions: Our study emphasizes the importance of a thorough histopathological examination of the surgical specimen, which can provide significant data for the assessment of the progression of an AM [World Health Organization (WHO) grade 2] with bone invasion. AM infiltration in adjacent bone and muscle increases the rate of tumor recurrence and decreases PFS over a follow-up period of 60 months.

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Tumor recurrence in parasagittal and falcine atypical meningiomas invading the superior sagittal sinus

Cited by 12 publications

References 91 publications

Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

A radiomics model enables prediction venous sinus invasion in meningioma

Clinicopathological characteristics and prognostic factors of atypical meningiomas with bone invasion: a retrospective analysis of nine cases and literature review

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