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Intracranial papillary meningioma: a clinicopathologic study of 30 cases at a single institution
Xiao-Qiang Wang1, Hong Chen, Lin Zhao
1‡Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China; §Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, China; ¶Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Background:
Papillary meningioma (PM) is an uncommon meningioma subtype, and the clinical characteristics remain unclear.
Objective:
To determine the clinical characteristics and prognosis of PM.
Methods:
The clinical data of 30 PM patients were collected, the samples were reexamined, and the patients' prognoses were based on clinical observations and calculated according to the Kaplan-Meier method.
Results:
The 30 patients included 16 males and 14 females (median: 34.0 years upon initial diagnosis). Of the 48 intracranial operations in the 30 patients, total removal was attained in 34 surgeries, and subtotal removal in 14 surgeries. Radiotherapy was provided in 20 patients. In 40 specimens with follow-up, 29 attained the positive aggressive factors. Six tumors showed positive progestogen receptor (PR) combined with negative Bcl-2. The median follow-up period was 39.0 months. Tumor recurrence occurred in 18 patients (median: 17.0 months); the recurrence rates following total removal and subtotal removal were 57.1% and 100%, respectively. Fourteen patients died of the recurrence. In the univariate analyses, positive aggressive factors (P = .021), positive PR combined with negative Bcl-2 immunoreactivity (P = .011), the extent of resection (P = .001), and radiotherapy (P = .002) were significantly related to progression-free survival. The MIB-1 labeling index was not significantly related to progression-free survival (P = .88).
Conclusion:
PM is a rare subtype of meningioma with a tendency of recurrence. The extent of resection is an important prognosis factor. The presence of positive histopathological index increases the recurrence risk. Positive PR combined with negative Bcl-2 immunoreaction might predict a good prognosis. Postoperative radiotherapy may play a vital role in prolonging the time to tumor recurrence.
Insights
Papillary meningioma (PM) is a rare brain tumor subtype. Complete surgical removal and specific histopathological factors significantly impact recurrence risk and prognosis, highlighting the importance of radiotherapy.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Papillary meningioma (PM) is an uncommon subtype of meningioma.
- The clinical characteristics and prognostic factors of PM are not well-defined.
Purpose of the Study:
- To elucidate the clinical characteristics of PM.
- To determine the prognostic factors influencing the outcomes of PM patients.
Main Methods:
- Retrospective analysis of clinical data from 30 PM patients.
- Histopathological re-examination of tumor samples.
- Prognosis assessment using clinical follow-up and Kaplan-Meier survival analysis.
Main Results:
- Tumor recurrence was observed in 18 patients (60%), with higher rates after subtotal resection (100%) compared to total removal (57.1%).
- Positive aggressive factors, positive progesterone receptor (PR) with negative Bcl-2, extent of resection, and radiotherapy were significantly associated with progression-free survival.
- Positive PR combined with negative Bcl-2 may indicate a favorable prognosis, while radiotherapy showed a role in delaying recurrence.
Conclusions:
- Papillary meningioma is a rare subtype with a significant tendency for recurrence.
- Extent of resection is a critical prognostic factor for PM.
- Postoperative radiotherapy may be crucial in managing PM recurrence and improving patient outcomes.
