Predictive factors for high-grade transformation in benign meningiomas

Area of Science:

• Neurosurgery
• Oncology
• Pathology

Background:

• Meningiomas are typically slow-growing benign tumors.
• Recurrence after surgery can lead to malignant transformation into atypical meningiomas.
• Predicting this progression is crucial for patient management.

Purpose of the Study:

• To identify radiological and histopathological factors predicting tumor progression from benign to atypical meningioma.
• To investigate predictors of high-grade transformation (HGT) in recurrent meningiomas.

Main Methods:

• Retrospective review of 14 patients with benign meningioma who underwent HGT between 2001-2017.
• Matched controls (1:4) of patients with benign meningioma without recurrence for at least 60 months.
• Multivariate analysis to identify significant predictors of transformation.

Main Results:

• The median time to transformation was 63 months.
• An increased mitotic index was a significant predictor of HGT (OR, 10.409; P=0.027).
• Prominent peritumoral edema was not a statistically significant predictor (P=0.054).

Conclusions:

• An elevated mitotic index can predict high-grade transformation in benign meningiomas.
• Tumors with high transformation risk warrant closer observation and management.
• This finding aids in refining surveillance strategies for meningioma patients.