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Benign versus atypical meningiomas: Risk factors predicting recurrence
Affiliations- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
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Abstract
The aim of the study is to determine which clinic, radiologic, and surgical characteristics of benign and atypical meningioma are associated with tumor progression.
Methods335 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.
Results291 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.
ConclusionPial 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
The aim of the study is to determine which clinic, radiologic, and surgical characteristics of benign and atypical meningioma are associated with tumor progression.
Methods335 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.
Results291 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.
ConclusionPial 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.
Keywords
Benign meningioma, Atypical meningioma, Tumor recurrence, Prognosis, Pial invasion
About this articleTitle
Benign versus atypical meningiomas: Risk factors predicting recurrence
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
1-10
Page views
465
Article views/downloads
978
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
