• World Neurosurg · Dec 2020

    Multicenter Study

    Surgical treatment and predictive factors for atypical meningiomas: a multicentric experience.

    • Mauro Dobran, Alessandra Marini, Bruno Splavski, Kresimir Rotim, Valentina Liverotti, Davide Nasi, and Maurizio Iacoangeli.
    • Clinic of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedali Riuniti, Ancona, Italy. Electronic address: dobran@libero.it.
    • World Neurosurg. 2020 Dec 1; 144: e1-e8.

    BackgroundAtypical meningiomas are characterized by a high rate of recurrence and shorter overall survival (OS) compared with grade I meningioma. Predictive parameters for OS and recurrence-free survival (RFS) are controversial.MethodsPatient age, sex, preoperative symptoms, tumor localization, size, Simpson grade, postoperative complications, extent of resection, number of mitoses, MIB1 proliferation index, brain invasion, postoperative radiotherapy, and clinical outcome (Karnofsky performance scale [KPS] postoperatively and at long-term follow-up) were evaluated. Data regarding recurrence rate, mortality, OS, and RFS at 1-, 3-, and 5-year follow-up were also collected. Median follow-up was 76 months; all patients had at least 3 years of follow-up.ResultsBetween 2007 and 2017, 73 patients underwent surgery for atypical meningiomas (World Health Organization grade II) at 2 centers. Preoperative KPS score >80 as well as 1-month, 6-month, and 1-year follow-up KPS scores were related to better OS. Postoperative complications did not modify OS and RFS. Gross total removal (Simpson grade I, II) was achieved in 80.8% of patients. RFS was statistically influenced by extent of resection (P = 0.002). MIB1 proliferation index >8 was a negative predictive factor for recurrence at univariate and multivariate analysis (P = 0.001 and P = 0.021). Radiotherapy was statistically related to a worse outcome. The incidence of recurrence was 38%. RFS was 98.6% at 1-year follow-up, 81.1% at 3 years, and 57.5% at 5 years. All patients were alive at 1-year follow-up. OS was 90.5% at 3-year follow-up and 78.8% at 5-year follow-up.ConclusionsDespite some limitations, our study demonstrates that aggressive surgical treatment achieving a gross total removal is a positive predictive parameter for RFS as well as a good clinical outcome (KPS score >80) and is related to a longer OS.Copyright © 2020 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…