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Meningioma recurrence
Tibor Hortobágyi1, János Bencze2, Gréta Varkoly2
1Division of Neuropathology, Institute of Pathology, University of Debrecen, Debrecen, Nagyerdei krt. 98., H-4032, Hungary.
Abstract:
Meningioma accounts for more than 30% of all intracranial tumours. It affects mainly the elderly above the age of 60, at a female:male ratio of 3:2. The prognosis is variable: it is usually favourable with no progression in tumour grade and no recurrence in WHO grade 1 tumours. However, a minority of tumours represent atypical (grade 2) or anaplastic (grade 3) meningiomas; this heterogeneity is also reflected in histopathological appearances. Irrespective of the grade, the size of the tumour and the localisation may have severe, sometimes lethal consequences. Following neurosurgical interventions to remove the tumour, recurrence and progression in WHO grade may occur. Our knowledge on predisposing histomorphological and molecular factors of recurrence is rather limited. These can be classified as I) demographic II) environmental, III) genetic and epigenetic IV) imaging, V) neuropathological, and VI) neurosurgical. In view of the complex background of tumour recurrence, the recognition of often subtle signs of increased risk of recurrence requires close collaboration of experts from several medical specialties. This multidisciplinary approach results in better therapy and fewer complications related to tumour recurrence.
Insights
Meningiomas, common brain tumors, can recur after surgery. Identifying risk factors through multidisciplinary collaboration is key for better treatment and fewer complications.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas constitute over 30% of intracranial tumors, predominantly affecting individuals over 60 with a 3:2 female-to-male ratio.
- Tumor prognosis varies significantly, with WHO grade 1 tumors generally having a favorable outlook, while atypical (grade 2) and anaplastic (grade 3) meningiomas exhibit greater heterogeneity and risk.
- Tumor size and location can lead to severe consequences, and recurrence or grade progression can occur even after surgical removal.
Purpose of the Study:
- To review and synthesize current knowledge on factors predisposing to meningioma recurrence.
- To highlight the limited understanding of histomorphological and molecular factors influencing recurrence.
- To emphasize the need for a multidisciplinary approach in recognizing subtle signs of increased recurrence risk.
Main Methods:
- Review of existing literature on meningioma recurrence.
- Classification of predisposing factors into demographic, environmental, genetic/epigenetic, imaging, neuropathological, and neurosurgical categories.
- Emphasis on the importance of collaborative expert review.
Main Results:
- Knowledge regarding predisposing factors for meningioma recurrence remains limited.
- Recurrence risk is influenced by a complex interplay of various factors.
- Subtle signs indicating increased risk often require specialized expertise.
Conclusions:
- A comprehensive understanding of meningioma recurrence requires integrating diverse data from multiple medical specialties.
- Multidisciplinary collaboration is essential for accurate risk assessment and improved patient outcomes.
- Enhanced understanding and early identification of recurrence risk factors can lead to more effective therapeutic strategies and reduced complications.
