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Intracranial Meningiomas, WHO Grade Il : Prognostic Implications of Clinicopathologic Features
Hyung-Sik Moon1, Shin Jung, Woo-Youl Jang
1Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School, Gwangju, Korea.
Objective:
Intracranial meningiomas are primarily benign tumors with a good prognosis. Although WHO grade II meningiomas are rare (2-10%), WHO grade II meningiomas have higher recurrence and mortality rates than benign. We evaluated the patient recurrence rate and investigated the prognostic factors of WHO grade II meningiomas.
Methods:
Between 1993 and 2005, 55 patients were diagnosed with WHO grade II meningiomas in our hospital. WHO grade II meningiomas (n=55) were compared with other WHO grades meningiomas (I, n=373; and III, n=20). The patients had a median age of 48.4 years (range, 14-17 years), a male-to-female ratio of 26 : 29, and a mean follow-up time of 45 months (range, 3-175 months).
Results:
In WHO grade II meningiomas, only the extent of resection was a significant prognostic factor. Post-operative radiotherapy had no significant influence on tumor recurrence (p=0.053). The relative risk of recurrence was significantly higher in WHO grade II meningiomas with incomplete resection (10/27, RR=37%) than in WHO grade II meningiomas with complete resection (4/28, RR=14%) regardless of post-operative radiotherapy. In the incomplete resection group, Simpson grade III or IV had a significantly high risk of recurrence regardless of post-operative RT (n=3, RR=100%) However, if the degree of resection was Simpson grade II, the recurrence rate was similar to the complete resection group even though post-operative RT was not performed.
Conclusion:
Complete resection was the most powerful independent predictive factor of the recurrence rate in WHO grade II meningiomas. Post-operative adjuvant RT was not a significant factor in this study.
Insights
Complete resection is the most crucial factor for preventing recurrence in World Health Organization (WHO) grade II meningiomas. Post-operative radiotherapy did not significantly impact tumor recurrence rates in this study.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Intracranial meningiomas are typically benign but WHO grade II meningiomas, though rare, present higher recurrence and mortality risks.
- Understanding prognostic factors for WHO grade II meningiomas is critical for improving patient outcomes.
Purpose of the Study:
- To evaluate the recurrence rate of World Health Organization (WHO) grade II meningiomas.
- To identify significant prognostic factors influencing recurrence in WHO grade II meningiomas.
Main Methods:
- A retrospective analysis of 55 patients diagnosed with WHO grade II meningiomas between 1993 and 2005.
- Comparison of WHO grade II meningiomas with WHO grades I (n=373) and III (n=20) tumors.
- Analysis of prognostic factors including extent of resection and post-operative radiotherapy.
Main Results:
- The extent of tumor resection was the only significant prognostic factor for recurrence in WHO grade II meningiomas.
- Incomplete resection, particularly Simpson grade III or IV, was associated with a significantly higher risk of recurrence (RR=37%) compared to complete resection (RR=14%).
- Post-operative radiotherapy did not demonstrate a significant influence on tumor recurrence (p=0.053).
Conclusions:
- Complete surgical resection is the most powerful independent predictor of recurrence for WHO grade II meningiomas.
- Adjuvant post-operative radiotherapy was not found to be a significant factor in preventing recurrence in this patient cohort.
