J Korean Neurosurg Soc.  2017 Nov;60(6):661-666. 10.3340/jkns.2017.0303.008.

Prognostic Factors of Atypical Meningioma: Overall Survival Rate and Progression Free Survival Rate

• Lee JH
• Kim OL
• Seo YB
• Choi JH

• KMID: 2395785
• DOI: http://doi.org/10.3340/jkns.2017.0303.008

Abstract

OBJECTIVE
Atypical meningioma is rare tumor and there is no accurate guide line for optimal treatment. This retrospective study analyzed the prognostic factors, the effect of different methods of treatments and the behavior of atypical meningioma.
METHODS
Thirty six patients were diagnosed as atypical meningioma, among 273 patients who were given a diagnosis of meningioma in the period of 2002 to 2015. Age, gender, tumor location, Ki 67, Simpson grade and treatment received were analyzed. We studied the correlation between these factors with recurrence, overall survival rate and progression free survival.
RESULTS
Median overall survival time and progression free survival time are 60 and 53 (months). Better survival rate was observed for patients less than 50 years old but with no statistical significance (p=0.322). And patients with total resection compared with subtotal resection also showed better survival rate but no statistical significance (p=0.744). Patients with a tumor located in skull base compared with patients with a tumor located in brain convexity and parasagittal showed better progression free survival (p=0.048). Total resection is associated with longer progression-free survival than incomplete resection (p=0.018).
CONCLUSION
We confirmed that Simpson grade was significant factor for statistically affect to progression free survival in univariate analysis. In case of skull base atypical tumor, it is analyzed that it has more recurrence than tumor located elsewhere. Overall survival was not affected statistically by patient age, gender, tumor location, Ki 67, Simpson grade and treatment received in this study.

Keyword

Malignant meningioma; Mortality; Progression free survival

MeSH Terms

Brain
Diagnosis
Disease-Free Survival*
Humans
Meningioma*
Mortality
Recurrence
Retrospective Studies
Skull Base
Survival Rate*

Figure

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  Fig. 1 The extent of surgical resection had a significant impact on PFS. PFS: progression free survival, Total: total removal of mass, Subtotal: subtotal removal of mass.

Reference

References

1. Aghi MK, Carter BS, Cosgrove GR, Ojemann RG, Amin-Hanjani S, Martuza RL, et al. Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery. 64:56–60. discussion 60. 2009.

2. Akeyson EW, McCutcheon IE. Management of benign and aggressive intracranial meningiomas. Oncology (Williston Park). 10:747–756. discussion 756–759. 1996.

3. Bruna J, Brell M, Ferrer I, Gimenez-Bonafe P, Tortosa A. Ki-67 proliferative index predicts clinical outcome in patients with atypical or anaplastic meningioma. Neuropathology. 27:114–120. 2007.

4. Cao X, Hao S, Wu Z, Wang L, Jia G, Zhang L, et al. Treatment response and prognosis after recurrence of atypical meningiomas. World Neurosurg. 84:1014–1019. 2015.

5. Champeaux C, Wilson E, Brandner S, Shieff C, Thorne L. World Health Organization grade III meningiomas. A retrospective study for outcome and prognostic factors assessment. Br J Neurosurg. 29:693–698. 2015.

6. Chen WY, Liu HC. Atypical (anaplastic) meningioma: relationship between histologic features and recurrence--a clinicopathologic study. Clin Neuropathol. 9:74–81. 1990.

7. Coke CC, Corn BW, Werner-Wasik M, Xie Y, Curran WJ Jr. Atypical and malignant meningiomas: an outcome report of seventeen cases. J Neurooncol. 39:65–70. 1998.

8. Condra KS, Buatti JM, Mendenhall WM, Friedman WA, Marcus RB Jr, Rhoton AL. Benign meningiomas: primary treatment selection affects survival. Int J Radiat Oncol Biol Phys. 39:427–436. 1997.

9. Dziuk TW, Woo S, Butler EB, Thornby J, Grossman R, Dennis WS, et al. Malignant meningioma: an indication for initial aggressive surgery and adjuvant radiotherapy. J Neurooncol. 37:177–188. 1998.

10. Goyal LK, Suh JH, Mohan DS, Prayson RA, Lee J, Barnett GH. Local control and overall survival in atypical meningioma: a retrospective study. Int J Radiat Oncol Biol Phys. 46:57–61. 2000.

11. Hug EB, Devries A, Thornton AF, Munzenride JE, Pardo FS, Hedley-Whyte ET, et al. Management of atypical and malignant meningiomas: role of high-dose, 3D-conformal radiation therapy. J Neurooncol. 48:151–160. 2000.

12. Jo K, Park HJ, Nam DH, Lee JI, Kong DS, Park K, et al. Treatment of atypical meningioma. J Clin Neurosci. 17:1362–1366. 2010.

13. Louis D, Scheithauer B, Budka H, Von Deimling A, Kepes J, Kleihues P, et al. Pathology and genetics of tumors of the nervous system. Kleihues P, Cavenee WK, editors. World Health Organization Classification of Tumours: Pathology and Genetics: Tumors of the Nervous System. ed 2. Lyon: IARC Press;2000. 1:p. 176–184.

14. Mahmood A, Caccamo DV, Tomecek FJ, Malik GM. Atypical and malignant meningiomas: a clinicopathological review. Neurosurgery. 33:955–963. 1993.

15. McCarthy BJ, Davis FG, Freels S, Surawicz TS, Damek DM, Grutsch J, et al. Factors associated with survival in patients with meningioma. J Neurosurg. 88:831–839. 1998.

16. Modha A, Gutin PH. Diagnosis and treatment of atypical and anaplastic meningiomas: a review. Neurosurgery. 57:538–550. discussion 538–550. 2005.

17. Palma L, Celli P, Franco C, Cervoni L, Cantore G. Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg. 86:793–800. 1997.

18. Park HJ, Kang HC, Kim IH, Park SH, Kim DG, Park CK, et al. The role of adjuvant radiotherapy in atypical meningioma. J Neurooncol. 115:241–247. 2013.

19. Perry A, Stafford SL, Scheithauer BW, Suman VJ, Lohse CM. Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol. 21:1455–1465. 1997.

20. Tomura N, Takahashi S, Sakuma I, Omachi K, Watarai J, Sasajima T, et al. Neuroradiological findings of atypical meningiomas. CMIG Extra: Cases. 28:33–39. 2004.

21. Torp SH, Lindboe CF, Granli US, Moen TM, Nordtømme T. Comparative investigation of proliferation markers and their prognostic relevance in human meningiomas. Clin Neuropathol. 20:190–195. 2001.

22. Zaher A, Abdelbari Mattar M, Zayed DH, Ellatif RA, Ashamallah SA. Atypical meningioma: a study of prognostic factors. World Neurosurg. 80:549–553. 2013.