Christian Mirian1, Simon Skyrman2,3,4, Jiri Bartek1,2,3,4, Lasse Rehné Jensen1, Lars Kihlström2, Petter Förander2,3,4, Abiel Orrego5, Tiit Mathiesen1,3,4,6. 1. Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 2. Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 4. Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 5. Department of Pathology, Karolinska University Hospital, Stockholm, Sweden. 6. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: There are examples of incongruence between the WHO grade and clinical course in meningioma patients. This incongruence between WHO grade and recurrence has led to search for other prognostic histological markers. OBJECTIVE: To study the correlation between the Ki-67 proliferative index (PI), risk of recurrence, and recurrence rates in meningioma patients. METHODS: We prospectively collected pathological diagnosis of de novo consecutive meningiomas. In total, we followed 159 patients with clinical controls until recurrence, death, or emigration. We estimated the correlation between risk of recurrence and Ki-67 PI when adjusted for age at diagnosis, sex, WHO grade, extent of surgical resection, and tumor location. We estimated the cumulative incidence of recurrence when considering death without recurrence a competing risk. We report recurrence rates per 100 person-years. RESULTS: A 1%-point increase of Ki-67 PI yielded a hazard ratio of 1.12 (95% CI: 1.01-1.24) in a multivariate analysis. The cumulative incidence of recurrence was 3% for Ki-67 0% to 4% vs 19% for Ki-67 > 4% meningiomas after 1 yr, but 24% vs 35%, respectively, after 10 yr. There was no significant difference in mean Ki-67 PI between nonrecurrent and recurrent meningioma in a 2-sample t-test (P = .08). The strongest relationship was detected between Ki-67 PI and time to recurrence: Ki-67 < 4% meningiomas recurred after median 4.8 yr, compared to 0.60 to 0.75 yr for patients with higher Ki-67 PI. CONCLUSION: Ki-67 PI was a marker for time to recurrence rather than a predictor of recurrence. Ki-67 PI may be utilized for patient tailored follow-up.
BACKGROUND: There are examples of incongruence between the WHO grade and clinical course in meningioma patients. This incongruence between WHO grade and recurrence has led to search for other prognostic histological markers. OBJECTIVE: To study the correlation between the Ki-67 proliferative index (PI), risk of recurrence, and recurrence rates in meningioma patients. METHODS: We prospectively collected pathological diagnosis of de novo consecutive meningiomas. In total, we followed 159 patients with clinical controls until recurrence, death, or emigration. We estimated the correlation between risk of recurrence and Ki-67 PI when adjusted for age at diagnosis, sex, WHO grade, extent of surgical resection, and tumor location. We estimated the cumulative incidence of recurrence when considering death without recurrence a competing risk. We report recurrence rates per 100 person-years. RESULTS: A 1%-point increase of Ki-67 PI yielded a hazard ratio of 1.12 (95% CI: 1.01-1.24) in a multivariate analysis. The cumulative incidence of recurrence was 3% for Ki-67 0% to 4% vs 19% for Ki-67 > 4% meningiomas after 1 yr, but 24% vs 35%, respectively, after 10 yr. There was no significant difference in mean Ki-67 PI between nonrecurrent and recurrent meningioma in a 2-sample t-test (P = .08). The strongest relationship was detected between Ki-67 PI and time to recurrence: Ki-67 < 4% meningiomas recurred after median 4.8 yr, compared to 0.60 to 0.75 yr for patients with higher Ki-67 PI. CONCLUSION: Ki-67 PI was a marker for time to recurrence rather than a predictor of recurrence. Ki-67 PI may be utilized for patient tailored follow-up.
Authors: Lasse Rehné Jensen; Andrea Daniela Maier; Atle Lomstein; Thomas Graillon; Maya Hrachova; Daniela Bota; Alejandro Ruiz-Patiño; Oscar Arrieta; Andrés Felipe Cardona; Roberta Rudà; Julia Furtner; Ulrich Roeckle; Paul Clement; Matthias Preusser; David Scheie; Helle Broholm; Bjarne Winther Kristensen; Jane Skjøth-Rasmussen; Morten Ziebell; Tina Nørgaard Munch; Kåre Fugleholm; Martin A Walter; Tiit Mathiesen; Christian Mirian Journal: Neurosurg Rev Date: 2022-08-19 Impact factor: 2.800
Authors: Omaditya Khanna; Anahita Fathi Kazerooni; Christopher J Farrell; Michael P Baldassari; Tyler D Alexander; Michael Karsy; Benjamin A Greenberger; Jose A Garcia; Chiharu Sako; James J Evans; Kevin D Judy; David W Andrews; Adam E Flanders; Ashwini D Sharan; Adam P Dicker; Wenyin Shi; Christos Davatzikos Journal: Neurosurgery Date: 2021-10-13 Impact factor: 5.315