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Published on: January 29, 2018
Recurrence-associated chromosomal anomalies in meningiomas: Single-institution study and a systematic review with
Waldemar Och1, Tomasz Szmuda2, Beata Sikorska3
1Neurosurgery Department, Regional Specialist Hospital, Olsztyn, Poland.
Abstract:
Complete removal of a meningioma (MG) does not guarantee relapse-free survival. Alterations on several chromosomes responsible for MG recurrence were suggested, although their role was not validated by a systematic review. Following the analysis of own 161 cases, all previously published data has been collected for evidence synthesis. Based on own series, WHO grade >I (odds ratio (OR)=92.0; 95%CI: 19.1-443.5) and a combination of loss of heterozygosity (LOH) on 1p and 14q (OR=10.2; 95%CI: 19-55.7) were the independent recurrence-specific prognosticators. The deleterious role of LOH on 1p/14q was demonstrated in a subset of parasagittal and falcine MGs. A total of 742 cases and 10 studies were pooled for the Individual Patient Data and Aggregate Data models of meta-analysis, respectively. The prognostic role of WHO classification (OR=90.4) and anomaly of chromosome 14 (OR=3.5) was confirmed. LOH on 14 showed lesser impact on recurrence than suggested by the WHO grading (area under the curve 0.65 for LOH vs. 0.74 for WHO). Fixed effect model of meta-analysis provided high summarized OR values for 1p (OR=5.4; 95%CI: 3.6-8.1) and 14q (OR=7.6; 95%CI: 4.3-13.6), and low for chromosome 22 (OR=1.6; 95%CI: 1.1-2.4). Final appraisal of recurrence-associated chromosomal alterations indicated that arms 1p and 14q deserve attention while predicting MG recurrence.
Insights
Meningioma recurrence is linked to WHO grade and specific chromosomal changes, particularly on chromosome arms 1p and 14q. These genetic alterations, alongside tumor grade, are key predictors for meningioma (MG) relapse after surgery.
Area of Science:
- Neuro-oncology
- Genetics
- Cancer Research
Background:
- Complete surgical removal of meningioma (MG) does not always prevent recurrence.
- Previous studies suggested chromosomal alterations contribute to MG recurrence, but lacked systematic validation.
Purpose of the Study:
- To systematically review and synthesize evidence on chromosomal alterations associated with meningioma recurrence.
- To identify independent prognosticators for meningioma recurrence-free survival.
Main Methods:
- Analysis of 161 original cases combined with a systematic review of published data.
- Meta-analysis (Individual Patient Data and Aggregate Data models) of 742 cases from 10 studies.
- Statistical analysis to determine independent recurrence-specific prognosticators.
Main Results:
- WHO grade >I and combined loss of heterozygosity (LOH) on 1p and 14q were independent predictors of meningioma recurrence.
- Meta-analysis confirmed the prognostic role of WHO classification and chromosome 14 anomalies.
- Chromosomal arms 1p and 14q showed significant association with recurrence, with LOH on 14 having a lesser impact than WHO grading.
Conclusions:
- WHO grade and chromosomal alterations, especially on arms 1p and 14q, are crucial for predicting meningioma recurrence.
- Loss of heterozygosity on 1p and 14q are significant prognostic markers for meningioma recurrence.
- Further attention to chromosomal arms 1p and 14q is warranted in predicting meningioma recurrence.
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