• Luckchai Phonwijit, Cheewin Khawprapa, and Bunpot Sitthinamsuwan.
• Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
• World Neurosurg. 2017 Nov 1; 107: 698-705.

ObjectiveAtypical meningioma has a higher recurrence rate than benign meningioma. The mainstay of treatment is surgery with or without radiation therapy (RT). The objective of this study was to investigate progression-free survival (PFS) and factors associated with postoperative recurrence in patients with atypical meningioma.MethodsPatients with diagnoses of atypical menigioma who underwent surgery at Siriraj Hospital during the 2004 to 2014 study period were included. Features potentially associated with PFS and tumor recurrence from clinical records, operative records, and neuroimaging studies were evaluated and analyzed.ResultsOne hundred twenty-six patients (mean age, 55 years) were included. The median PFS was 55 months. The 5-year and 10-year PFS rates were 72.5% and 32%, respectively. The median follow-up duration was 52 months. In multivariate analysis, tumor location (convexity, parasagittal/falcine, intraventricular, skull base) (P = 0.003), and pial invasion (hazard ratio [HR]: 2.02; P = 0.045) were significantly associated with tumor recurrence. Postoperative RT was associated with reduction in tumor recurrence in both univariate (odds ratio: 0.48; P = 0.039) and multivariate analysis (HR: 0.42; P = 0.005).ConclusionsTumor location and pial invasion were significantly correlated with increased incidence of tumor recurrence, and postoperative RT was found to be significantly associated with decreased tumor progression and recurrence.Copyright © 2017 Elsevier Inc. All rights reserved.

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