Olivia Claire Barrett1, James R Hackney2, Andrew M McDonald2, Christopher D Willey2, Markus Bredel2, John B Fiveash2. 1. Department of Radiation Oncology, Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: oliviaclaireb@gmail.com. 2. Department of Radiation Oncology, Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.
Abstract
PURPOSE: To assess the local recurrence rate of gross totally resected atypical meningiomas and evaluate for pathologic predictors of recurrence. METHODS AND MATERIALS: All patients meeting the 2016 World Health Organization grade 2 meningioma criteria who received gross total resection were included in this retrospective analysis. A neuropathologist re-reviewed all surgical specimens for the following pathologic factors: brain invasion, macronuclei, necrosis, sheeting architecture, hypercellularity, high nuclear to cytoplasmic ratio, Ki67 proliferative index, mitotic number, and choroid or clear cell histology. Local recurrence and salvage therapy were recorded. RESULTS: Ninety-seven patients met the inclusion criteria and had a median radiographic follow-up of 53 months (range, 3-153). Necrosis was present in 41 specimens (42%), and brain invasion occurred in 30 (31%). Seventy-six patients (78%) had 3 of 5 World Health Organization grade 2 qualifying atypical features. Median mitotic number and Ki67 index were 3 (0-12) and 15 (2%-55%), respectively. Only Ki67 proliferative index and mitotic number predict for local recurrence. The Kaplan-Meier estimate of local recurrence was 30.3% at 3 years. CONCLUSIONS: In this cohort of gross totally resected atypical meningioma followed with observation, local recurrence occurred in 30.3% at 3 years. Ki67 index and mitotic number predict for local failure and could help stratify patients who would benefit from adjuvant therapy.
PURPOSE: To assess the local recurrence rate of gross totally resected atypical meningiomas and evaluate for pathologic predictors of recurrence. METHODS AND MATERIALS: All patients meeting the 2016 World Health Organization grade 2 meningioma criteria who received gross total resection were included in this retrospective analysis. A neuropathologist re-reviewed all surgical specimens for the following pathologic factors: brain invasion, macronuclei, necrosis, sheeting architecture, hypercellularity, high nuclear to cytoplasmic ratio, Ki67 proliferative index, mitotic number, and choroid or clear cell histology. Local recurrence and salvage therapy were recorded. RESULTS: Ninety-seven patients met the inclusion criteria and had a median radiographic follow-up of 53 months (range, 3-153). Necrosis was present in 41 specimens (42%), and brain invasion occurred in 30 (31%). Seventy-six patients (78%) had 3 of 5 World Health Organization grade 2 qualifying atypical features. Median mitotic number and Ki67 index were 3 (0-12) and 15 (2%-55%), respectively. Only Ki67 proliferative index and mitotic number predict for local recurrence. The Kaplan-Meier estimate of local recurrence was 30.3% at 3 years. CONCLUSIONS: In this cohort of gross totally resected atypical meningioma followed with observation, local recurrence occurred in 30.3% at 3 years. Ki67 index and mitotic number predict for local failure and could help stratify patients who would benefit from adjuvant therapy.
Authors: Collin L Kent; Yvonne M Mowery; Olayode Babatunde; Ato O Wright; Ian Barak; Frances McSherry; James E Herndon; Allan H Friedman; Ali Zomorodi; Katherine Peters; Annick Desjardins; Henry Friedman; William Sperduto; John P Kirkpatrick Journal: Adv Radiat Oncol Date: 2021-12-24
Authors: Agbolahan A Sofela; David A Hilton; Sylwia Ammoun; Daniele Baiz; Claire L Adams; Emanuela Ercolano; Michael D Jenkinson; Kathreena M Kurian; Mario Teo; Peter C Whitfield; Felix Sahm; C Oliver Hanemann Journal: Int J Mol Sci Date: 2021-01-08 Impact factor: 5.923
Authors: Laura Zima; Michael J Baine; Richard Sleightholm; Bangchen Wang; Michael Punsoni; Michele Aizenberg; Chi Zhang Journal: J Clin Med Res Date: 2021-03-19