[Prognosis in meningiomas. Relevance of morphologic studies and clinical risk factors]

Since the introduction of the WHO-classification of tumours of the central nervous system in 1979, meningiomas are subdivided in 8 histological types and graded I to IV. The basis for this classification were histopathological investigations combined with clinical follow-up data. Since the introduction of immunocytochemistry as a diagnostic tool in neurooncology, morphological methods have gained renewed interest among neurosurgeons and neurologists. Some of the more recent developments, as well as the classical methods of the neuropathologist, are discussed here, and the results of the impact of morphology on prognosis is discussed on 139 own cases. Beside the histopathological grading, the application of so called proliferative markers as Ki-67 and BUdR seems to be most promising in the prediction of recurrences. Clinical parameters as patients age, preoperative physical status, tumor size and location on the other hand are of particular importance concerning postoperative mortality.