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Published on: July 5, 2021
Prediction of pediatric meningioma recurrence by preoperative MRI assessment
Hao Li1,2, Meng Zhao1,2, Shuo Wang1,2
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Beijing, 100050, China.
Abstract:
Preoperative identification of high-recurrent pediatric meningiomas with MRI features would help clinicians to make optimal treatment strategies; however, the relationships between radiological features and recurrence of meningiomas in pediatric population have not been clearly demonstrated yet. The aim of this study is to identify preoperative MRI features which are significant risk factors for recurrence of pediatric meningiomas. From January 2005 to December 2012, we retrospectively reviewed 52 pediatric meningiomas in terms of preoperative MRI features and their clinical data and followed them up from 22 to 128 months (mean 63 months) after the initial surgery. The relationships between these radiological findings and relapse-free survival (RFS) time were assessed initially with univariate Cox analysis and then corrected by multivariate Cox analysis. According to univariate analysis, irregular shape, narrow-based attachment, and skull base location were significantly correlated with shorter time to recurrences of meningiomas in pediatric patients. When corrected by multivariate analysis, irregular shape (P = 0.05; OR 3.442, 95 % CI 1.001-11.831) and narrow-based attachment (P = 0.004; OR 7.164, 95 % CI 1.894-27.09) were strong independent predictive factors for worse RFS of pediatric meningiomas. In pediatric population, narrow-based attachment and irregular shape were significantly correlated with recurrences of meningiomas. Our results could help clinicians to make optimal therapeutic strategies for pediatric patients with intracranial meningiomas before surgery.
Insights
Preoperative MRI features like irregular shape and narrow-based attachment are key indicators for predicting recurrence in pediatric meningiomas. Identifying these risk factors aids in planning optimal treatment strategies for children with these brain tumors.
Area of Science:
- Neuro-oncology
- Pediatric Neurosurgery
- Radiology
Background:
- Pediatric meningiomas are rare tumors, and predicting recurrence preoperatively is crucial for treatment planning.
- Current understanding of radiological predictors for pediatric meningioma recurrence remains limited.
Purpose of the Study:
- To identify preoperative MRI features associated with recurrence in pediatric meningiomas.
- To establish independent predictive factors for relapse-free survival (RFS) in this population.
Main Methods:
- Retrospective review of 52 pediatric meningiomas with preoperative MRI and clinical data.
- Follow-up duration ranged from 22 to 128 months (mean 63 months).
- Statistical analysis included univariate and multivariate Cox regression to assess relationships between MRI features and RFS.
Main Results:
- Univariate analysis identified irregular shape, narrow-based attachment, and skull base location as significant predictors of recurrence.
- Multivariate analysis confirmed irregular shape (P=0.05; OR 3.442) and narrow-based attachment (P=0.004; OR 7.164) as independent risk factors for worse RFS.
- These features were significantly correlated with meningioma recurrence in pediatric patients.
Conclusions:
- Narrow-based attachment and irregular shape on preoperative MRI are significant predictors of recurrence in pediatric meningiomas.
- These findings can assist clinicians in developing tailored therapeutic strategies before surgery.
- Improved preoperative risk stratification can optimize management for pediatric intracranial meningiomas.
