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Primary resected meningiomas: relapses and proliferation markers
Jean-Pierre Kalala1, Jacques Caemaert, Leo De Ridder
1Department of Neurosurgery, University Hospital, De Pintelaan 185, Ghent, Belgium.
In Vivo (Athens, Greece)
|September 17, 2004
Summary
Complete resection of meningiomas is recommended to prevent relapses. Proliferation markers and incomplete resection are key risk factors for tumor recurrence, influencing patient outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningioma relapses are common during patient follow-up.
- Factors influencing meningioma relapse, such as sex, age, surgical treatment, and mitotic frequency, remain debated.
Purpose of the Study:
- To investigate the risk factors associated with meningioma tumor relapse after surgical intervention.
- To evaluate the predictive value of proliferation markers and resection extent on meningioma recurrence.
Main Methods:
- A cohort of 125 meningioma patients undergoing surgery between 1986 and 1997 were followed for up to 15 years.
- Tumor relapse was assessed using MRI and TDM. Proliferation markers (Ki67, PCNA) were scored at resection.
- Univariate and multivariate analyses, including Cox hazards models, were used to identify risk factors for relapse.
Main Results:
- Of 125 patients, 26 experienced tumor relapse, predominantly from subtotal resections.
- Tumor relapse rates at 3, 5, 10, and 15 years were 8.8%, 13.6%, 17.6%, and 20.8%, respectively.
- In multivariate analysis, incomplete resection and proliferation markers were significant risk factors (p<0.05) for meningioma relapse.
Conclusions:
- Total resection of meningiomas is recommended to minimize the risk of relapse.
- Resection type and proliferation markers are significant predictors of tumor recurrence.
- Proliferation markers, while significant at a group level, are not reliable for individual patient prognostication.