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The importance of considering competing risks in recurrence analysis of intracranial meningioma.
Mirian, Christian; Jensen, Lasse Rehné; Juratli, Tareq A; Maier, Andrea Daniela; Torp, Sverre H; Shih, Helen A; Morshed, Ramin A; Young, Jacob S; Magill, Stephen T; Bertero, Luca; Stummer, Walter; Spille, Dorothee Cäcilia; Brokinkel, Benjamin; Oya, Soichi; Miyawaki, Satoru; Saito, Nobuhito; Proescholdt, Martin; Kuroi, Yasuhiro; Gousias, Konstantinos; Simon, Matthias; Moliterno, Jennifer; Prat-Acin, Ricardo; Goutagny, Stéphane; Prabhu, Vikram C; Tsiang, John T; Wach, Johannes; Güresir, Erdem; Yamamoto, Junkoh; Kim, Young Zoon; Lee, Joo Ho; Koshy, Matthew; Perumal, Karthikeyan; Baskaya, Mustafa K; Cannon, Donald M; Shrieve, Dennis C; Suh, Chang-Ok; Chang, Jong Hee; Kamenova, Maria; Straumann, Sven; Soleman, Jehuda; Eyüpoglu, Ilker Y; Catalan, Tony; Lui, Austin; Theodosopoulos, Philip V; McDermott, Michael W; Wang, Fang; Guo, Fuyou; Góes, Pedro; de Paiva Neto, Manoel Antonio; Jamshidi, Aria.
Affiliation
  • Mirian C; Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark. Christian.mirian.larsen@regionh.dk.
  • Jensen LR; Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark.
  • Juratli TA; Department of Neurosurgery, Division of Neuro-Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.
  • Maier AD; Department of Neurosurgery, Laboratory of Translational Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA.
  • Torp SH; Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark.
  • Shih HA; Department of Pathology, Bartholin Institute, Rigshospitalet, Copenhagen University Hospital , Copenhagen, Denmark.
  • Morshed RA; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian, University of Science and Technology (NTNU), Laboratory Centre, St. Olavs Hospital, NO-7491, Trondheim, Norway.
  • Young JS; Department of Pathology, Laboratory Centre, St. Olavs Hospital, NO-7030, Trondheim, Norway.
  • Magill ST; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Bertero L; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Stummer W; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Spille DC; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Brokinkel B; Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, Illinois, USA.
  • Oya S; Pathology Unit, Department of Medical Sciences, University and Città Della Salute E Della Scienza University Hospital of Turin, Turin, Italy.
  • Miyawaki S; Department of Neurosurgery, University of Münster, Münster, Germany.
  • Saito N; Department of Neurosurgery, University of Münster, Münster, Germany.
  • Proescholdt M; Department of Neurosurgery, University of Münster, Münster, Germany.
  • Kuroi Y; Institute for Neuropathology, University of Münster, Münster, Germany.
  • Gousias K; Department of Neurosurgery, Saitama Medical Center/University, Saitama, Japan.
  • Simon M; Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Moliterno J; Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.
  • Prat-Acin R; Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
  • Goutagny S; Department of Neurosurgery, Adachi Medical Center, Tokyo Women's Medical University, Tokyo, Japan.
  • Prabhu VC; Department of Neurosurgery, Athens Medical Center, Athens, Greece.
  • Tsiang JT; Department of Neurosurgery, Bethel Clinic University of Bielefeld Medical Center, Bielefeld, Germany.
  • Wach J; Department of Neurosurgery, Yale School of Medicine Yale New Haven Hospital, Smilow Cancer Hospital, New Haven, USA.
  • Güresir E; Department of Neurosurgery, Hospital La Fe, Valencia, Spain.
  • Yamamoto J; Department of Neurosurgery, Université Paris Cité, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
  • Kim YZ; Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Illinois, USA.
  • Lee JH; Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Illinois, USA.
  • Koshy M; Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
  • Perumal K; Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
  • Baskaya MK; Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
  • Cannon DM; Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
  • Shrieve DC; Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • Suh CO; Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Illinois, USA.
  • Chang JH; Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  • Kamenova M; Department of Neurosurgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  • Straumann S; Department of Radiation Oncology Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
  • Soleman J; Department of Radiation Oncology Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
  • Eyüpoglu IY; Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Catalan T; Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lui A; Department of Neurosurgery, University Hospital Basel, Basel, Switzerland.
  • Theodosopoulos PV; Department of Neurosurgery, University Hospital Basel, Basel, Switzerland.
  • McDermott MW; Department of Neurosurgery, University Hospital Basel, Basel, Switzerland.
  • Wang F; Department of Neurosurgery, Division of Neuro-Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.
  • Guo F; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Góes P; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • de Paiva Neto MA; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
  • Jamshidi A; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
J Neurooncol ; 166(3): 503-511, 2024 Feb.
Article in En | MEDLINE | ID: mdl-38336917
ABSTRACT

BACKGROUND:

The risk of recurrence is overestimated by the Kaplan-Meier method when competing events, such as death without recurrence, are present. Such overestimation can be avoided by using the Aalen-Johansen method, which is a direct extension of Kaplan-Meier that accounts for competing events. Meningiomas commonly occur in older individuals and have slow-growing properties, thereby warranting competing risk analysis. The extent to which competing events are considered in meningioma literature is unknown, and the consequences of using incorrect methodologies in meningioma recurrence risk analysis have not been investigated.

METHODS:

We surveyed articles indexed on PubMed since 2020 to assess the usage of competing risk analysis in recent meningioma literature. To compare recurrence risk estimates obtained through Kaplan-Meier and Aalen-Johansen methods, we applied our international database comprising ~ 8,000 patients with a primary meningioma collected from 42 institutions.

RESULTS:

Of 513 articles, 169 were eligible for full-text screening. There were 6,537 eligible cases from our PERNS database. The discrepancy between the results obtained by Kaplan-Meier and Aalen-Johansen was negligible among low-grade lesions and younger individuals. The discrepancy increased substantially in the patient groups associated with higher rates of competing events (older patients with high-grade lesions).

CONCLUSION:

The importance of considering competing events in recurrence risk analysis is poorly recognized as only 6% of the studies we surveyed employed Aalen-Johansen analyses. Consequently, most of the previous literature has overestimated the risk of recurrence. The overestimation was negligible for studies involving low-grade lesions in younger individuals; however, overestimation might have been substantial for studies on high-grade lesions.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Meningeal Neoplasms / Meningioma Type of study: Etiology_studies / Risk_factors_studies Limits: Aged / Humans Language: En Journal: J Neurooncol Year: 2024 Type: Article Affiliation country: Denmark
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Meningeal Neoplasms / Meningioma Type of study: Etiology_studies / Risk_factors_studies Limits: Aged / Humans Language: En Journal: J Neurooncol Year: 2024 Type: Article Affiliation country: Denmark