BACKGROUND: Macroscopic total resection with removal of involved dura and bone does not always prevent the recurrence of meningioma of histologically benign subtype. Many causative factors have been investigated, although the mechanism of recurrence remains unclear. Vascular endothelial growth factor (VEGF) is a key factor in meningiomas neovascularization, and the authors investigated whether VEGF expression can predict the recurrence of histologically benign meningiomas after macroscopic total resection. METHODS: Fifty-four patients with supratentorial convexity meningiomas were investigated at least 3 years after surgery or until tumor recurrence to clarify risk factors for recurrence. Patients were restricted to Simpson Grade 1 resection only, and the authors excluded multiple meningiomas, neurofibromatosis, and atypical and anaplastic meningiomas. Correlation between recurrence and the following factors were statistically analyzed: age, gender, tumor volume, tumor shape, bone change, brain edema, vascular supply, histologic subtype, MIB-1 labeling index (LI), and VEGF expression. RESULTS: Of the 54 patients with meningioma, 34 were positive (24: +1; 10: +2) for VEGF, and 20 were negative. Six (11.1%) meningiomas recurred during the follow-up period. Multivariate analysis revealed that high levels of expression of VEGF constituted the most useful predictor of recurrence (P = 0.005), followed by high MIB-1 LI (P = 0.039). The other factors were not significant. The tumor recurrence, when it occurred, was within the brain and not durally based. CONCLUSIONS: The current results suggest that high levels of VEGF expression are significantly related to the recurrence of meningioma. VEGF secretion from microscopic residue remaining after surgery may induce neovascularization, which promotes the recurrence of meningioma.
BACKGROUND: Macroscopic total resection with removal of involved dura and bone does not always prevent the recurrence of meningioma of histologically benign subtype. Many causative factors have been investigated, although the mechanism of recurrence remains unclear. Vascular endothelial growth factor (VEGF) is a key factor in meningiomas neovascularization, and the authors investigated whether VEGF expression can predict the recurrence of histologically benign meningiomas after macroscopic total resection. METHODS: Fifty-four patients with supratentorial convexity meningiomas were investigated at least 3 years after surgery or until tumor recurrence to clarify risk factors for recurrence. Patients were restricted to Simpson Grade 1 resection only, and the authors excluded multiple meningiomas, neurofibromatosis, and atypical and anaplastic meningiomas. Correlation between recurrence and the following factors were statistically analyzed: age, gender, tumor volume, tumor shape, bone change, brain edema, vascular supply, histologic subtype, MIB-1 labeling index (LI), and VEGF expression. RESULTS: Of the 54 patients with meningioma, 34 were positive (24: +1; 10: +2) for VEGF, and 20 were negative. Six (11.1%) meningiomas recurred during the follow-up period. Multivariate analysis revealed that high levels of expression of VEGF constituted the most useful predictor of recurrence (P = 0.005), followed by high MIB-1 LI (P = 0.039). The other factors were not significant. The tumor recurrence, when it occurred, was within the brain and not durally based. CONCLUSIONS: The current results suggest that high levels of VEGF expression are significantly related to the recurrence of meningioma. VEGF secretion from microscopic residue remaining after surgery may induce neovascularization, which promotes the recurrence of meningioma.
Authors: Anne Durand; François Labrousse; Anne Jouvet; Luc Bauchet; Michel Kalamaridès; Philippe Menei; Robert Deruty; Jean Jacques Moreau; Michelle Fèvre-Montange; Jacques Guyotat Journal: J Neurooncol Date: 2009-06-27 Impact factor: 4.130
Authors: Jeffrey J Raizer; Sean A Grimm; Alfred Rademaker; James P Chandler; Kenji Muro; Irene Helenowski; Laurie Rice; Katie McCarthy; Sandra K Johnston; Maciej M Mrugala; Marc Chamberlain Journal: J Neurooncol Date: 2014-01-22 Impact factor: 4.130
Authors: Janneke Schuuring; Mark Rijpkema; Hans Bernsen; Pieter Bernsen; Richard van der Maazen; Johannes Kaanders; Albert van der Kogel; Arend Heerschap Journal: J Neurooncol Date: 2002-04 Impact factor: 4.130