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Benign versus atypical meningiomas: risk factors predicting recurrence
Arkadiusz Nowak1, Tomasz Dziedzic1, Piotr Krych1
1Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
Neurologia I Neurochirurgia Polska
|February 11, 2015
Summary
Pial invasion predicts meningioma recurrence in both benign and atypical tumors. Atypical meningiomas with bone involvement or brain edema also show increased progression, highlighting key factors for monitoring tumor recurrence.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Benign (WHO Grade I) and atypical (WHO Grade II) meningiomas have different prognoses.
- Predictors of recurrence for these tumor types require further elucidation.
Purpose of the Study:
- To identify clinical, radiologic, and surgical factors associated with tumor progression in benign and atypical meningiomas.
- To determine the impact of these factors on progression-free survival and recurrence.
Main Methods:
- Retrospective analysis of 335 patients undergoing gross-total resection of intracranial meningiomas (2000-2009).
- Minimum 3-year follow-up to assess progression-free survival and tumor recurrence.
- Kaplan-Meier and multivariate analyses to evaluate clinical, radiological, and surgical features.
Main Results:
- 34 of 335 meningiomas recurred during a median 82-month follow-up.
- Pial invasion (subpial plane dissection) was linked to increased progression in both benign and atypical meningiomas.
- Bone involvement and peritumoral brain edema were associated with increased progression in atypical meningiomas.
- WHO Grade II (atypical) and pial invasion were significant predictors of recurrence in multivariate analysis.
Conclusions:
- Pial invasion is a critical predictor of recurrence for both benign and atypical meningiomas.
- Bone involvement and peritumoral brain edema are significant factors for progression in atypical meningiomas.
- Early recurrence in atypical meningiomas occurs within 4 years post-resection.
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