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Pre-operative predictive factors of grade II and III meningiomas

Year 2021, , 1 - 6, 16.12.2020
https://doi.org/10.31067/acusaglik.834505

Abstract

Purpose:Meningiomas are the most common primary intracranial tumors. They are graded into three pathologic grades. Surgical gross total resection is the definitive treatment of meningiomas, but follow-up or stereotactic radiosurgery is sometimes advised for asymptomatic, incidentally diagnosed meningiomas. For a decision making, pre-operative prediction of Grade II and III meningiomas which are more aggressive clinically, is important. We have reviewed our intracranial meningioma series, based on their clinical, radiological, and location, to analyze the predictive factors of Grade II and III meningiomas.
Patients and Methods:The clinical, radiological, operative and pathological reports of patients who were operated for intracranial meningiomas between September 1986 and July 2019 have been reviewed retrospectively from our patient database. Their age, sex, tumor location, absence or presence of peritumoral edema, and the pathological grade of meningiomas have been noted. The predictive effect of age, sex, peritumoral edema and location of tumor is analyzed statistically for pathological grade.
Results:There were 1401 patients with intracranial meningiomas, 1015 of them were female, 386 were male (female/male=2.6). Their mean age was 52.2 years. There were 1219 Grade I, 164 Grade II, and 18 Grade III meningiomas. Male sex, and non-skull base location were predictive for Grade II and III meningiomas.
Conclusion:While advising conservative treatment (follow-up, or stereotactic radiosurgery) for asymptomatic, incidental meningiomas, it should be kept in mind that male sex, and/or non-skull base location are risk factors for the more aggressive Grade II and III meningiomas.

References

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Derece II ve III meningiomların preoperatif prediktif faktörleri

Year 2021, , 1 - 6, 16.12.2020
https://doi.org/10.31067/acusaglik.834505

Abstract

Amaç:Meningiomlar en sık görülen primer intrakranyal patolojilerdir. Patolojik olarak üç dereceleri vardır. Cerrahi ile total rezeksiyon belirleyici tedavi olmakla beraber, özellikle asemptomatik ve insidental vakalarda, yakın takip veya stereotaktik radyocerrahi tercih edilebilmektedir. Cerrahi tedavi ile konservatif tedavi arasında karar verebilmek açısından, daha agresif klinik seyir gösterebilen Derece II ve III meningiomların, ön görülebilmesi önem taşımaktadır. Çalışmamızda, meningiom serimizde kayıtlı hastaların klinik, radyolojik ve yerleşim özelliklerine göre patolojik derecelerinde prediktif olabilecek etkenleri araştırdık.
Hastalar ve Yöntem:İntrakranyal meningiom veri tabanımıza kayıtlı, Eylül 1986 ile Temmuz 2019 arasında opere edilen hastaların klinik, radyolojik, cerrahi ve patolojik raporları retrospektif olarak tarandı. Yaş, cinsiyet, tümör yerleşimi, peritümöral ödem olup olmaması, patolojik derecesi not edildi. Patoloji dereceleri açısından yaşın, cinsiyetin, ödemin ve tümör yerleşiminin prediktif olup olmadığı istatistiki yöntemler ile araştırıldı.
Bulgular:Veri tabanımızda 1401 intrakranyal meningiom hastası tespit edildi. Hastaların 1015’i kadın, 386’sı erkekti (kadın/erkek=2,6). Ortalama yaşları 52,2 yıl idi. Bin iki yüz on dokuz Derece I, 164 Derece II, 18 Derece III meningiom vardı. Erkek cinsiyeti ve/veya kafa tabanı dışı yerleşim Derece II ve III meningiomlar için prediktif olarak tespit edildi.
Sonuç:Asemptomatik, insidental olarak tespit edilen meningiomlarda, konservatif tedavi (yakın takip veya stereotaktik radyocerrahi) tercih edildiğinde, erkek ve/veya kafa tabanı dışı yerleşimli olanların, daha agresif davranışlı olan Derece II veya III olma ihtimalinin daha yüksek olduğu unutulmamalıdır.

References

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  • 2. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of tumors of the central nervous system: A summary. Acta Neuropathol [Internet]. 2016 May 9 [cited 2016 May 12];131(6):803–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27157931
  • 3. Liang R-F, Xiu Y-J, Wang X, Li M, Yang Y, Mao Q, et al. The potential risk factors for atypical and anaplastic meningiomas: Clinical series of 1,239 cases. Int J Clin Exp Med [Internet]. 2014 [cited 2019 Oct 12];7(12):5696–700. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25664093
  • 4. Li D, Jiang P, Xu S, Li C, Xi S, Zhang J, et al. Survival impacts of extent of resection and adjuvant radiotherapy for the modern management of high-grade meningiomas. J Neurooncol [Internet]. 2019 Sep 6 [cited 2019 Sep 29]; Available from: http://link.springer.com/10.1007/s11060-019-03278-w
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  • 6. Jenkinson MD, Javadpour M, Haylock BJ, Young B, Gillard H, Vinten J, et al. The ROAM/EORTC-1308 trial: Radiation versus observation following surgical resection of atypical meningioma: Study protocol for a randomised controlled trial. Trials [Internet]. 2015 Dec 14 [cited 2019 Sep 29];16(1):519. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26576533
  • 7. Jenkinson MD, Weber DC, Haylock BJ, Mallucci CL, Zakaria R, Javadpour M. Atypical meningoma: Current management dilemmas and prospective clinical trials. J Neurooncol [Internet]. 2015 Jan 26 [cited 2019 Sep 29];121(1):1–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25258253
  • 8. van Nieuwenhuizen D, Klein M, Stalpers LJA, Leenstra S, Heimans JJ, Reijneveld JC. Differential effect of surgery and radiotherapy on neurocognitive functioning and health-related quality of life in WHO grade I meningioma patients. J Neurooncol [Internet]. 2007 Sep 13 [cited 2019 Oct 22];84(3):271–8. Available from: http://link.springer.com/10.1007/s11060-007-9366-7
  • 9. Minniti G, Amichetti M, Enrici RM. Radiotherapy and radiosurgery for benign skull base meningiomas. Radiat Oncol [Internet]. 2009 Oct 14 [cited 2019 Oct 20];4:42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19828022
  • 10. Starke RM, Przybylowski CJ, Sugoto M, Fezeu F, Awad AJ, Ding D, et al. Gamma Knife radiosurgery of large skull base meningiomas. J Neurosurg [Internet]. 2015 Feb [cited 2019 Oct 20];122(2):363–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25479122
  • 11. Islim AI, Mohan M, Moon RDC, Srikandarajah N, Mills SJ, Brodbelt AR, et al. Incidental intracranial meningiomas: A systematic review and meta-analysis of prognostic factors and outcomes. J Neurooncol [Internet]. 2019 Apr 17 [cited 2019 Oct 20];142(2):211–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30656531
  • 12. Czyz M, Radwan H, Li JY, Filippi CG, Tykocki T, Schulder M. Fractal analysis may improve the preoperative identification of atypical meningiomas. Neurosurgery [Internet]. 2017 Feb 1 [cited 2019 Oct 20];80(2):300–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28173535
  • 13. Filippi CG, Demopoulos A, Radwan H, Li J, Schulder M, Czyz M. Diffusion-weighted imaging and MRI-based fractal analysis as quantitative metrics for preoperative prediction of atypia in meningiomas. Neuro Oncol [Internet]. 2018 Jan 31 [cited 2019 Oct 20];20(suppl_1):i12–i12. Available from: https://academic.oup.com/neuro-oncology/article/20/suppl_1/i12/4831313
  • 14. Morin O, Chen WC, Nassiri F, Susko M, Magill ST, Vasudevan HN, et al. Integrated models incorporating radiologic and radiomic features predict meningioma grade, local failure, and overall survival. Neuro-Oncology Adv [Internet]. 2019 May 1 [cited 2019 Oct 20];1(1):vdz011. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31608329
  • 15. Maier H, Öfner D, Hittmair A, Kitz K, Budka H. Classic, atypical, and anaplastic meningioma: Three histopathological subtypes of clinical relevance. J Neurosurg [Internet]. 1992 Oct [cited 2019 Oct 28];77(4):616–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1527622
  • 16. Mahmood A, Caccamo D V., Tomecek FJ, Malik GM. Atypical and malignant meningiomas: A clinicopathological review. Neurosurgery [Internet]. 1993 Dec [cited 2019 Oct 6];33(6):955–63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8134008
  • 17. McCarthy BJ, Davis FG, Freels S, Surawicz TS, Damek DM, Grutsch J, et al. Factors associated with survival in patients with meningioma. J Neurosurg [Internet]. 1998 May [cited 2019 Oct 28];88(5):831–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9576250
  • 18. Sade B, Chahlavi A, Krishnaney A, Nagel S, Choi E, Lee JH. World Health Organization grades II and III meningiomas are rare in the cranial base and spine. Neurosurgery [Internet]. 2007 Dec 1 [cited 2019 Oct 22];61(6):1194–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18162898
  • 19. Pasquier D, Bijmolt S, Veninga T, Rezvoy N, Villa S, Krengli M, et al. Atypical and malignant meningioma: Outcome and prognostic factors in 119 irradiated patients. A multicenter, retrospective study of the Rare Cancer Network. Int J Radiat Oncol Biol Phys [Internet]. 2008 Aug 1 [cited 2019 Oct 12];71(5):1388–93. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0360301607047608
  • 20. Kane AJ, Sughrue ME, Rutkowski MJ, Shangari G, Fang S, McDermott MW, et al. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer [Internet]. 2011 Mar 15 [cited 2019 Oct 6];117(6):1272–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21381014
  • 21. Cornelius JF, Slotty PJ, Steiger HJ, Hänggi D, Polivka M, George B. Malignant potential of skull base versus non-skull base meningiomas: Clinical series of 1,663 cases. Acta Neurochir (Wien) [Internet]. 2013 Mar 15 [cited 2019 May 10];155(3):407–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23318687
  • 22. Hammouche S, Clark S, Wong AHL, Eldridge P, Farah JO. Long-term survival analysis of atypical meningiomas: Survival rates, prognostic factors, operative and radiotherapy treatment. Acta Neurochir (Wien) [Internet]. 2014 Aug 26 [cited 2019 Oct 16];156(8):1475–81. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24965072
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There are 44 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Mustafa Güdük

Baran Bozkurt

Murat Şakir Ekşi

Murat İmre Usseli

Mustafa Necmettin Pamir

Publication Date December 16, 2020
Submission Date October 5, 2020
Published in Issue Year 2021

Cite

EndNote Güdük M, Bozkurt B, Ekşi MŞ, Usseli Mİ, Pamir MN (December 1, 2020) Pre-operative predictive factors of grade II and III meningiomas. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 12 1 1–6.