Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome.
J Neurooncol
; 145(3): 469-477, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31713016
ABSTRACT
PURPOSE:
For meningiomas, the 2016 revision of the WHO classification introduced brain invasion per se as a sufficient condition to classify as grade II. We analyzed whether meningiomas previously graded as WHO grade I differ in prognosis depending on the presence of microscopic brain invasion.METHODS:
A consecutive series of patients with intracranial meningioma WHO grade I (± brain invasion) at two neurosurgical departments was analyzed retrospectively. Cox regression models on progression-free survival (PFS) and Kaplan-Meier survival estimates were performed.RESULTS:
875 adult patients were included. Histological diagnosis of brain invasion was confirmed in 28 patients. Median follow-up was 73 months. In univariate and multivariate models, gross total resection gained favorable prognostic influence for PFS (p < 0.001, HR 0.237, CI 0.170-0.382). 170 patients with the brain/meningioma interface present in histopathological specimen were separately analyzed as a subgroup. Importantly, presence of brain invasion did not reach significance for PFS, even in the subgroup with available specimen of brain/meningioma interface (p = 0.787, HR 0.852, CI 0.268-2.710 and p = 0.811, HR 0.848, CI 0.222-3.246, respectively). Patients with and without brain invasion did not differ in terms of age, tumor location and extent of resection, but were more likely to receive radiotherapy (p = 0.03) of tumor remnants. However, subgroup analysis of non-irradiated tumors revealed no prognostic influence of brain invasion (p = 0.749, HR 0.772, CI 0.158-3.767).CONCLUSIONS:
In this bi-institutional series, brain invasion was frequent among meningiomas WHO grade I when brain/meningioma interface was available for histology (16.5%). However, brain invasion did not impact early recurrence.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Meníngeas
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Meningioma
Tipo de estudo:
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article