Faculty Collaboration Database

Outcome of resection of WHO Grade II meningioma and correlation of pathological and radiological predictive factors for recurrence. J Clin Neurosci 2016 Sep;31:112-21

Date

07/19/2016

Pubmed ID

27427214

DOI

10.1016/j.jocn.2016.02.021

Scopus ID

2-s2.0-84978818156 (requires institutional sign-in at Scopus site)   56 Citations

Abstract

This study investigated whether extent of surgical resection (Simpson and Shinshu grade) along with pathological and radiological factors influence the tumor control and recurrence-free survival (RFS) of patients with World Health Organization (WHO) grade II meningiomas. The clinical, radiological and surgical notes on the 59 patients with WHO grade II meningioma managed at our institution over 20years were retrospectively reviewed. In this study, median survival time was 41months. The overall recurrence rate in Simpson grades I and II resection was 31%. In grades III and IV, the overall recurrence rate was 73%, and this high recurrence rate in these groups was confined within 5years. In Cox regression analysis, combined data of grades (I and II)/complete resection showed a significant difference in RFS compared to grades (III and IV)/subtotal resection (p=0.0001). A similar trend of RFS (p=0.0001) was observed with the Shinshu grading system of resection. In addition, a Ki-67% marker for proliferation less than 15% (p=0.029), absence of certain radiological features including heterogeneous enhancement, cyst formation and peritumoral edema (p=0.006), and repeat surgery for recurrent meningioma was associated with better survival (p=0.014). However, radiosurgery did not have a beneficial role in the treatment of recurrence of atypical meningioma. The Simpson grading system is the primary predictor of recurrence of WHO grade II meningioma after resection. In addition, certain pathological and radiological features need to be considered as possible factors of recurrence after resection. Lastly, depending on the likely risks and surgical morbidity, repeat surgical resection should be performed for recurrent atypical meningioma.

Author List

Nanda A, Bir SC, Konar S, Maiti T, Kalakoti P, Jacobsohn JA, Guthikonda B

Author

Jamie A. Jacobsohn MD Associate Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Female
Humans
Male
Meningeal Neoplasms
Meningioma
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local
Prognosis
Young Adult