Toshiki Endo1,2, Ayumi Narisawa3, Hosam Shata Mohamed Ali3,4, Kensuke Murakami3, Takashi Watanabe5, Mika Watanabe6, Hidefumi Jokura7, Hidenori Endo8, Miki Fujimura3, Yukihiko Sonoda3, Teiji Tominaga3. 1. Department of Neurosurgery, Tohoku University, Graduate School of Medicine, 1-1 Seiryo Aoba, Sendai, Japan, 980-8574. endo@nsg.med.tohoku.ac.jp. 2. Department of Neurosurgery, Kohnan Hopsital, Sendai, Japan. endo@nsg.med.tohoku.ac.jp. 3. Department of Neurosurgery, Tohoku University, Graduate School of Medicine, 1-1 Seiryo Aoba, Sendai, Japan, 980-8574. 4. Department of Neurosurgery, Mansoura University, Mansoura, Egypt. 5. Division of Epidemiology, Department of Public Health & Forensic Medicine, Tohoku University, Graduate school of medicine, Sendai, Japan. 6. Department of Pathology, Tohoku University, Graduate school of medicine, Sendai, Japan. 7. Jiro Suzuki Memorial Gamma House, Furukawa Seiryou Hospital, Osaki, Japan. 8. Department of Neurosurgery, Kohnan Hopsital, Sendai, Japan.
Abstract
BACKGROUND: Atypical meningioma differs from Grade I meningioma in terms of high recurrence rate and short life expectancy. We evaluated the clinical course of atypical meningioma and investigated prognostic factors affecting its outcomes. METHOD: We reviewed 45 patients with atypical meningioma who underwent surgical intervention between January 2000 and December 2013. The mean age of the patients and mean follow-up period was 58.7 years and 81.0 months, respectively. Analyses included factors such as patient age, gender, location and size of tumor, extent of surgical resection (Simpson Grading System), and MIB-1 labeling index (LI). Univariate analysis was used to detect prognostic factors associated with recurrence and survival. RESULTS: The 5-year recurrence-free rate for all 45 patients was 58.4 %; 5- and 10-year survival rates were 83.2 % and 79.9 %, respectively. In univariate analyses, age >60 years, and MIB-1 LI correlated with disease recurrence, whereas age >60 years, subtotal surgical resection, MIB-1 LI, and indication for radiotherapy correlated with death. MIB-1 LI levels higher than 12.8 % and 19.7 % predicted recurrence and death, respectively. In our cohort, 26 patients received postoperative radiotherapy including conventional radiation (n = 21) or gamma knife radiosurgery (n = 5). Postoperative radiotherapy did not decrease recurrence rates in our cohort (p = 0.63). Six and two patients who died during the study period underwent conventional radiation and radiosurgery, respectively. CONCLUSIONS: Age, male gender, extent of surgical resection, and higher MIB-1 LI influenced the outcome of atypical meningioma. In our cohort, postoperative radiotherapy failed to provide long-term tumor control. Following incomplete surgical resection of atypical meningioma in elderly patients, adjuvant postoperative radiotherapy may not be an ideal treatment option, particularly when MIB-1 LI is higher than 19.7 %.
BACKGROUND:Atypical meningioma differs from Grade I meningioma in terms of high recurrence rate and short life expectancy. We evaluated the clinical course of atypical meningioma and investigated prognostic factors affecting its outcomes. METHOD: We reviewed 45 patients with atypical meningioma who underwent surgical intervention between January 2000 and December 2013. The mean age of the patients and mean follow-up period was 58.7 years and 81.0 months, respectively. Analyses included factors such as patient age, gender, location and size of tumor, extent of surgical resection (Simpson Grading System), and MIB-1 labeling index (LI). Univariate analysis was used to detect prognostic factors associated with recurrence and survival. RESULTS: The 5-year recurrence-free rate for all 45 patients was 58.4 %; 5- and 10-year survival rates were 83.2 % and 79.9 %, respectively. In univariate analyses, age >60 years, and MIB-1 LI correlated with disease recurrence, whereas age >60 years, subtotal surgical resection, MIB-1 LI, and indication for radiotherapy correlated with death. MIB-1 LI levels higher than 12.8 % and 19.7 % predicted recurrence and death, respectively. In our cohort, 26 patients received postoperative radiotherapy including conventional radiation (n = 21) or gamma knife radiosurgery (n = 5). Postoperative radiotherapy did not decrease recurrence rates in our cohort (p = 0.63). Six and two patients who died during the study period underwent conventional radiation and radiosurgery, respectively. CONCLUSIONS: Age, male gender, extent of surgical resection, and higher MIB-1 LI influenced the outcome of atypical meningioma. In our cohort, postoperative radiotherapy failed to provide long-term tumor control. Following incomplete surgical resection of atypical meningioma in elderly patients, adjuvant postoperative radiotherapy may not be an ideal treatment option, particularly when MIB-1 LI is higher than 19.7 %.
Authors: Kerstin A Kessel; Hanna Fischer; Markus Oechnser; Claus Zimmer; Bernhard Meyer; Stephanie E Combs Journal: Strahlenther Onkol Date: 2017-06-15 Impact factor: 3.621
Authors: Muhammad O Chohan; Christopher T Ryan; Ranjodh Singh; Ryan M Lanning; Anne S Reiner; Marc K Rosenblum; Viviane Tabar; Philip H Gutin Journal: Neurosurgery Date: 2018-06-01 Impact factor: 4.654
Authors: Karol P Budohoski; James Clerkin; Christopher P Millward; Philip J O'Halloran; Mueez Waqar; Seamus Looby; Adam M H Young; Mathew R Guilfoyle; Diana Fitzroll; Abel Devadass; Kieren Allinson; Michael Farrell; Mohsen Javadpour; Michael D Jenkinson; Thomas Santarius; Ramez W Kirollos Journal: Acta Neurochir (Wien) Date: 2018-06-30 Impact factor: 2.216