Dorothee Cäcilia Spille1, Katharina Heß1, Cristina Sauerland2, Nader Sanai3, Walter Stummer4, Werner Paulus1, Benjamin Brokinkel5. 1. Institute of Neuropathology, University Hospital Münster, Münster, Germany. 2. Institute of Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany. 3. Barrow Brain Tumor Research Center, Barrow Neurological Institute, 350 West Thomas Rd, Phoenix, Arizona, USA. 4. Department of Neurosurgery, University Hospital Münster, Münster, Germany. 5. Department of Neurosurgery, University Hospital Münster, Münster, Germany. Electronic address: benjamin.brokinkel@ukmuenster.de.
Abstract
OBJECTIVE: In meningioma, correlation of brain invasion with prognosis and clinical variables remains controversial. METHODS: Correlation of brain invasion with clinical and histopathologic variables was investigated in 467 patients with primary intracranial meningioma. RESULTS: Diffuse (n = 3; 10%), clusterlike (n = 11; 34%) or fingerlike (n = 18; 56%) invasion was detected in 32 patients (7%). Brain invasion was more common in males than in females (13% vs. 5%; odds ratio, 2.75; 95% confidence interval, 1.29-5.89; P = 0.009) and pattern of invasion differed between genders (P = 0.037). Brain invasion was absent in 401 benign meningiomas and present in 48% of 60 atypical (n = 29) and 50% of 6 anaplastic (n = 3) meningiomas (P < 0.001) but was independent of tumor location and extent of resection. Progression occurred in 11% and was more frequent (31% vs. 15%; P = 0.036) in invasive than in noninvasive tumors, but only after gross total resection and in univariate analyses, and independent of invasion pattern. In atypical meningiomas, frequency of adjuvant irradiation was similar comparing invasive and noninvasive tumors and grading solely based on brain invasion (n = 20; 33%), other World Health Organization (WHO) criteria (n = 31; 52%) or a combination of both (n = 9; 15%). Risk of recurrence was lower (hazard ratio, 0.258, 95% confidence interval, 0.09-0.734; P = 0.011) when grading exclusively based on brain invasion than when further WHO criteria were in addition present and the progression-free interval among the first was similar to benign tumors. CONCLUSIONS: Brain invasion and its patterns are correlated to gender. In contrast to the current WHO classification, invasion was associated with recurrence only after gross total resection and not independent of further histopathologic criteria of atypia.
OBJECTIVE: In meningioma, correlation of brain invasion with prognosis and clinical variables remains controversial. METHODS: Correlation of brain invasion with clinical and histopathologic variables was investigated in 467 patients with primary intracranial meningioma. RESULTS: Diffuse (n = 3; 10%), clusterlike (n = 11; 34%) or fingerlike (n = 18; 56%) invasion was detected in 32 patients (7%). Brain invasion was more common in males than in females (13% vs. 5%; odds ratio, 2.75; 95% confidence interval, 1.29-5.89; P = 0.009) and pattern of invasion differed between genders (P = 0.037). Brain invasion was absent in 401 benign meningiomas and present in 48% of 60 atypical (n = 29) and 50% of 6 anaplastic (n = 3) meningiomas (P < 0.001) but was independent of tumor location and extent of resection. Progression occurred in 11% and was more frequent (31% vs. 15%; P = 0.036) in invasive than in noninvasive tumors, but only after gross total resection and in univariate analyses, and independent of invasion pattern. In atypical meningiomas, frequency of adjuvant irradiation was similar comparing invasive and noninvasive tumors and grading solely based on brain invasion (n = 20; 33%), other World Health Organization (WHO) criteria (n = 31; 52%) or a combination of both (n = 9; 15%). Risk of recurrence was lower (hazard ratio, 0.258, 95% confidence interval, 0.09-0.734; P = 0.011) when grading exclusively based on brain invasion than when further WHO criteria were in addition present and the progression-free interval among the first was similar to benign tumors. CONCLUSIONS: Brain invasion and its patterns are correlated to gender. In contrast to the current WHO classification, invasion was associated with recurrence only after gross total resection and not independent of further histopathologic criteria of atypia.
Authors: Martha Nowosielski; Norbert Galldiks; Sarah Iglseder; Philipp Kickingereder; Andreas von Deimling; Martin Bendszus; Wolfgang Wick; Felix Sahm Journal: Neuro Oncol Date: 2017-11-29 Impact factor: 12.300
Authors: Maximilian Timme; Christian Thomas; Dorothee Cäcilia Spille; Walter Stummer; Heinrich Ebel; Christian Ewelt; Franz-Josef Hans; Uta Schick; Maximilian Puchner; Uwe Wildförster; Bernhard Bruns; Hans Axel Trost; Markus Holling; Oliver Grauer; Katharina Hess; Benjamin Brokinkel Journal: Neurosurg Rev Date: 2019-06-03 Impact factor: 3.042
Authors: Kira Marie Voß; Dorothee Cäcilia Spille; Cristina Sauerland; Eric Suero Molina; Caroline Brokinkel; Werner Paulus; Walter Stummer; Markus Holling; Astrid Jeibmann; Benjamin Brokinkel Journal: J Neurooncol Date: 2017-05-19 Impact factor: 4.130
Authors: Roland Goldbrunner; Pantelis Stavrinou; Michael D Jenkinson; Felix Sahm; Christian Mawrin; Damien C Weber; Matthias Preusser; Giuseppe Minniti; Morten Lund-Johansen; Florence Lefranc; Emanuel Houdart; Kita Sallabanda; Emilie Le Rhun; David Nieuwenhuizen; Ghazaleh Tabatabai; Riccardo Soffietti; Michael Weller Journal: Neuro Oncol Date: 2021-11-02 Impact factor: 13.029