Effectiveness of Postoperative Radiotherapy in Patients with Atypical Meningiomas After Gross Total Resection: Analysis of 260 Cases.

OBJECTIVE: It remains controversial whether patients with atypical meningiomas can benefit from postoperative radiotherapy (PORT) after gross total resection (GTR). This study aimed to explore the effectiveness of PORT in patients with atypical meningiomas after GTR based on our single-center data with a relatively large sample size. METHODS: Patients with atypical meningiomas who underwent GTR in our center were reviewed. Univariable and multivariable Cox proportional hazard models were conducted for survival analyses. Kaplan-Meier survival curves were generated, and 5-year progression-free survival (PFS) rates were calculated. RESULTS: This study enrolled 260 patients. PORT was not associated with PFS (P = 0.507). Sex (P = 0.006, hazard ratio 0.418, 95% confidence interval 0.224-0.781), age (P = 0.032, hazard ratio 1.032, 95% confidence interval 1.003-1.061), and tumor location (P = 0.026, hazard ratio 0.199, 95% confidence interval 0.048-0.824) were independent predictors of PFS. The 5-year PFS rate of patients receiving PORT (85.6%) was similar to that of patients not receiving PORT (84.8%). The 5-year PFS rate was 100% in patients with convexity atypical meningiomas regardless of whether or not they received PORT. CONCLUSIONS: PORT after GTR may not prolong PFS in patients with atypical meningiomas. Patients with convexity atypical meningiomas had favorable outcomes after GTR regardless of receipt of PORT.