Gui-Jun Zhang1, Yun-Sheng Zhang2, Guo-Bin Zhang1, Xiu-Juan Yan3, Cheng-Bei Li1, Li-Wei Zhang1, Da Li4, Zhen Wu5, Jun-Ting Zhang6. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dong Cheng District, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. 2. China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China; Brain Tumor Research Center, Beijing Neurosurgical Institute, Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing Laboratory of Biomedical Materials, Dongcheng District, Beijing, China. 3. China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Dong Cheng District, Beijing, China. 4. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dong Cheng District, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. Electronic address: lidaatlas@aliyun.com. 5. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dong Cheng District, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. Electronic address: wuzhen1966@aliyun.com. 6. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dong Cheng District, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. Electronic address: zhangjunting2003@aliyun.com.
Abstract
OBJECTIVE: Chordoid meningioma (CM) and clear-cell meningioma (CCM) are rare World Health Organization grade II meningioma subtypes. This study aimed to evaluate favorable factors and appropriate therapeutic strategies for these lesions. METHODS: We retrospectively reviewed clinical data from 111 cases of grade II meningiomas, including 55 cases of CM and 56 cases of CCM, between January 2011 and December 2015. RESULTS: The mean follow-up time of the rare World Health Organization grade II meningiomas (n = 111) was 45.3 months. In the CM group, 8 patients (14.5%) experienced recurrence, and 2 patients (3.6%) died. In the CCM group, 22 patients (39.3%) experienced recurrence, and 9 patients (16.1%) died. Significant differences were observed between the CM and CCM groups in tumor size (P = 0.019), history of surgery (P = 0.038), and peritumoral edema (P = 0.004). In the CM group, gross total resection was associated with favorable progression-free survival (hazard ratio, 0.144; 95% confidence interval, 0.029-0.714; P = 0.018). In the CCM group, univariate analyses showed that preoperative Karnofsky Performance Status <80 (P < 0.001), tumor size ≥5 cm (P = 0.015), tumor size (per-centimeter increase) (P = 0.022), bone invasion (P = 0.004), a history of surgery (P < 0.001), and subtotal resection (P = 0.009) were associated with worse progression-free survival. Male gender (P = 0.039), tumor size (per-centimeter increase) (P = 0.043), bone invasion (P = 0.030), and a history of surgery (P = 0.007) were associated with poor overall survival. CONCLUSIONS: This study showed that gross total resection should be achieved in grade II meningiomas. Patients with larger tumors and/or surgical histories had worse outcomes.
OBJECTIVE:Chordoid meningioma (CM) and clear-cell meningioma (CCM) are rare World Health Organization grade II meningioma subtypes. This study aimed to evaluate favorable factors and appropriate therapeutic strategies for these lesions. METHODS: We retrospectively reviewed clinical data from 111 cases of grade II meningiomas, including 55 cases of CM and 56 cases of CCM, between January 2011 and December 2015. RESULTS: The mean follow-up time of the rare World Health Organization grade II meningiomas (n = 111) was 45.3 months. In the CM group, 8 patients (14.5%) experienced recurrence, and 2 patients (3.6%) died. In the CCM group, 22 patients (39.3%) experienced recurrence, and 9 patients (16.1%) died. Significant differences were observed between the CM and CCM groups in tumor size (P = 0.019), history of surgery (P = 0.038), and peritumoral edema (P = 0.004). In the CM group, gross total resection was associated with favorable progression-free survival (hazard ratio, 0.144; 95% confidence interval, 0.029-0.714; P = 0.018). In the CCM group, univariate analyses showed that preoperative Karnofsky Performance Status <80 (P < 0.001), tumor size ≥5 cm (P = 0.015), tumor size (per-centimeter increase) (P = 0.022), bone invasion (P = 0.004), a history of surgery (P < 0.001), and subtotal resection (P = 0.009) were associated with worse progression-free survival. Male gender (P = 0.039), tumor size (per-centimeter increase) (P = 0.043), bone invasion (P = 0.030), and a history of surgery (P = 0.007) were associated with poor overall survival. CONCLUSIONS: This study showed that gross total resection should be achieved in grade II meningiomas. Patients with larger tumors and/or surgical histories had worse outcomes.