open access

Vol 49, No 1 (2015)
Original research articles
Submitted: 2014-10-03
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Benign versus atypical meningiomas: Risk factors predicting recurrence

Arkadiusz Nowak, Tomasz Dziedzic, Piotr Krych, Tomasz Czernicki, Przemysław Kunert, Andrzej Marchel
DOI: 10.1016/j.pjnns.2014.11.003
·
Neurol Neurochir Pol 2015;49(1):1-10.

open access

Vol 49, No 1 (2015)
Original research articles
Submitted: 2014-10-03

Abstract

Objective

The aim of the study is to determine which clinic, radiologic, and surgical characteristics of benign and atypical meningioma are associated with tumor progression.

Methods

335 patients who underwent gross-total resection of intracranial benign and atypical meningiomas between 2000 and 2009 were followed during the period of at least 3 years. Clinical, radiological and surgical features possibly associated with progression-free survival and influencing tumor recurrence were assessed.

Results

291 lesions were benign (WHO Grade I) and 44 were atypical (WHO Grade II). In the median follow-up period of 82 months 34 meningiomas recurred. The 3-, 5- and 10-year progression-free survival (PFS) rates for benign and atypical tumors were 99.7 and 81.4%, 97.5 and 69.7%, 87.5 and 69.7%, respectively. In a Kaplan–Meier analysis subpial plane of surgical dissection (pial invasion) was associated with increased tumor progression both in benign (p=0.0084) and atypical cohort (p=0.0104), and bone involvement (p=0.0033) and peritumoral brain edema (p=0.0073) were associated with increased tumor progression only in atypical meningiomas. In a multivariate analysis pial invasion and WHO Grade II type were significantly associated with tumor recurrence. All recurrences in atypical meningioma group occurred within 4 years of the surgical resection.

Conclusion

Pial invasion is an important predictor of tumor recurrence in benign and atypical meningiomas. In atypical meningiomas bone involvement and large peritumoral brain edema are associated with increased tumor progression.

Abstract

Objective

The aim of the study is to determine which clinic, radiologic, and surgical characteristics of benign and atypical meningioma are associated with tumor progression.

Methods

335 patients who underwent gross-total resection of intracranial benign and atypical meningiomas between 2000 and 2009 were followed during the period of at least 3 years. Clinical, radiological and surgical features possibly associated with progression-free survival and influencing tumor recurrence were assessed.

Results

291 lesions were benign (WHO Grade I) and 44 were atypical (WHO Grade II). In the median follow-up period of 82 months 34 meningiomas recurred. The 3-, 5- and 10-year progression-free survival (PFS) rates for benign and atypical tumors were 99.7 and 81.4%, 97.5 and 69.7%, 87.5 and 69.7%, respectively. In a Kaplan–Meier analysis subpial plane of surgical dissection (pial invasion) was associated with increased tumor progression both in benign (p=0.0084) and atypical cohort (p=0.0104), and bone involvement (p=0.0033) and peritumoral brain edema (p=0.0073) were associated with increased tumor progression only in atypical meningiomas. In a multivariate analysis pial invasion and WHO Grade II type were significantly associated with tumor recurrence. All recurrences in atypical meningioma group occurred within 4 years of the surgical resection.

Conclusion

Pial invasion is an important predictor of tumor recurrence in benign and atypical meningiomas. In atypical meningiomas bone involvement and large peritumoral brain edema are associated with increased tumor progression.

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Keywords

Benign meningioma, Atypical meningioma, Tumor recurrence, Prognosis, Pial invasion

About this article
Title

Benign versus atypical meningiomas: Risk factors predicting recurrence

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 1 (2015)

Pages

1-10

DOI

10.1016/j.pjnns.2014.11.003

Bibliographic record

Neurol Neurochir Pol 2015;49(1):1-10.

Keywords

Benign meningioma
Atypical meningioma
Tumor recurrence
Prognosis
Pial invasion

Authors

Arkadiusz Nowak
Tomasz Dziedzic
Piotr Krych
Tomasz Czernicki
Przemysław Kunert
Andrzej Marchel

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