open access

Vol 22, No 6 (2017)
Original research articles
Published online: 2017-11-01
Submitted: 2017-04-25
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Survival benefit of postoperative radiation in papillary meningioma: Analysis of the National Cancer Data Base

Whitney A. Sumner, Arya Amini, Todd C. Hankinson, Nicholas K. Foreman, Laurie E. Gaspar, Brian D. Kavanagh, Sana D. Karam, Chad G. Rusthoven, Arthur K. Liu
DOI: 10.1016/j.rpor.2017.10.001
·
Rep Pract Oncol Radiother 2017;22(6):495-501.

open access

Vol 22, No 6 (2017)
Original research articles
Published online: 2017-11-01
Submitted: 2017-04-25

Abstract

Aim/Background

Papillary meningioma represents a rare subset of World Health Organization (WHO) Grade III meningioma that portends an overall poor prognosis. There is relatively limited data regarding the benefit of postoperative radiation therapy (PORT). We used the National Cancer Data Base (NCDB) to compare overall survival (OS) outcomes of surgically resected papillary meningioma cases undergoing PORT compared to post-operative observation.

Materials and methods

The NCDB was queried for patients with papillary meningioma, diagnosed between 2004 and 2013, who underwent upfront surgery with or without PORT. Overall survival (OS) was determined using the Kaplan–Meier method. Univariate (UVA) and multivariate (MVA) analyses were performed.

Results

In total, 190 patients were identified; 89 patients underwent PORT, 101 patients were observed. Eleven patients received chemotherapy (6 with PORT, 5 without). 2-Year OS was significantly improved with PORT vs. no PORT (93.0% vs. 74.4%), as was 5-year OS (78.5% vs. 62.5%) (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.27–0.85; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.01). On MVA, patients receiving PORT had improved OS compared to observation (HR, 0.41; 95% CI, 0.22–0.76; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005). On subset analysis by age group, the benefit of PORT vs. no PORT was significant in patients ≤18 years (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]13), with 2-year OS of 85.7% vs. 50.0% (HR, 0.08; 95% CI, 0.01–0.80; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.032) and for patients >18 years (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]184), with 2-year OS of 94.7% vs. 76.1% (HR, 0.55; 95% CI, 0.31–1.00; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.049), respectively.

Conclusions

In this large contemporary analysis, PORT was associated with improved survival for both adult and pediatric patients with papillary meningioma. PORT should be considered in those who present with this rare, aggressive tumor.

Abstract

Aim/Background

Papillary meningioma represents a rare subset of World Health Organization (WHO) Grade III meningioma that portends an overall poor prognosis. There is relatively limited data regarding the benefit of postoperative radiation therapy (PORT). We used the National Cancer Data Base (NCDB) to compare overall survival (OS) outcomes of surgically resected papillary meningioma cases undergoing PORT compared to post-operative observation.

Materials and methods

The NCDB was queried for patients with papillary meningioma, diagnosed between 2004 and 2013, who underwent upfront surgery with or without PORT. Overall survival (OS) was determined using the Kaplan–Meier method. Univariate (UVA) and multivariate (MVA) analyses were performed.

Results

In total, 190 patients were identified; 89 patients underwent PORT, 101 patients were observed. Eleven patients received chemotherapy (6 with PORT, 5 without). 2-Year OS was significantly improved with PORT vs. no PORT (93.0% vs. 74.4%), as was 5-year OS (78.5% vs. 62.5%) (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.27–0.85; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.01). On MVA, patients receiving PORT had improved OS compared to observation (HR, 0.41; 95% CI, 0.22–0.76; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005). On subset analysis by age group, the benefit of PORT vs. no PORT was significant in patients ≤18 years (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]13), with 2-year OS of 85.7% vs. 50.0% (HR, 0.08; 95% CI, 0.01–0.80; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.032) and for patients >18 years (n[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]184), with 2-year OS of 94.7% vs. 76.1% (HR, 0.55; 95% CI, 0.31–1.00; p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.049), respectively.

Conclusions

In this large contemporary analysis, PORT was associated with improved survival for both adult and pediatric patients with papillary meningioma. PORT should be considered in those who present with this rare, aggressive tumor.

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Keywords

Meningioma; Postoperative radiation; PORT; National Cancer Data Base (NCDB)

About this article
Title

Survival benefit of postoperative radiation in papillary meningioma: Analysis of the National Cancer Data Base

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 6 (2017)

Pages

495-501

Published online

2017-11-01

DOI

10.1016/j.rpor.2017.10.001

Bibliographic record

Rep Pract Oncol Radiother 2017;22(6):495-501.

Keywords

Meningioma
Postoperative radiation
PORT
National Cancer Data Base (NCDB)

Authors

Whitney A. Sumner
Arya Amini
Todd C. Hankinson
Nicholas K. Foreman
Laurie E. Gaspar
Brian D. Kavanagh
Sana D. Karam
Chad G. Rusthoven
Arthur K. Liu

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