World Health Organization Grade III Meningiomas: A Retrospective Study at an Academic Medical Center
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Published on: July 5, 2021
Eduarda Sá-Marta1, José Luís Alves2, Olinda Rebelo3
1Department of Neurosurgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Background:
Meningiomas are the most common primary brain tumors and are generally considered benign. However, a rare subgroup of meningiomas, classified as World Health Organization (WHO) grade III meningiomas, can show extremely aggressive behavior and high rates of recurrence. Despite ongoing research, data on the clinical outcome of this subgroup of meningiomas are still limited.
Methods:
Medical records of patients with WHO grade III meningiomas diagnosed between 2000 and 2018 at the Coimbra University Hospital Center were retrospectively reviewed and several variables of interest and their relation to patients' survival were analyzed.
Results:
Of the 26 patients included in the final analysis, 23 had anaplastic meningiomas, 2 had papillary meningiomas, and 1 had a rhabdoid meningioma. Median overall survival and median progression-free survival were 2.45 and 1.22 years, respectively. Overall survival at 1, 2 and 5 years was 73%, 57%, and 35%, respectively. Adjuvant radiotherapy correlated with improved survival for subtotally resected meningiomas but not for gross totally resected meningiomas. There was a trend toward improved overall survival with gross total resection versus subtotal resection, but this difference failed to reach statistical significance.
Conclusions:
This study provides insight into the clinical outcomes of WHO grade III meningiomas and suggests that adjuvant radiotherapy may not be beneficial for patients who underwent gross total resection. This rare subset of meningiomas still portends a devastating prognosis and the impact of extent of resection and adjuvant therapies in these patients needs further clarification.
Insights
Aggressive World Health Organization (WHO) grade III meningiomas have poor outcomes. Adjuvant radiotherapy may improve survival for subtotal resections, but not gross total resections in these rare brain tumors.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Pathology
Background:
- Meningiomas are common primary brain tumors, typically benign.
- World Health Organization (WHO) grade III meningiomas represent a rare, aggressive subgroup with high recurrence rates.
- Limited data exists on the clinical outcomes for WHO grade III meningiomas.
Purpose of the Study:
- To analyze the clinical outcomes and survival data of patients with WHO grade III meningiomas.
- To investigate the impact of treatment modalities, including extent of resection and adjuvant radiotherapy, on patient survival.
Main Methods:
- Retrospective review of medical records for patients diagnosed with WHO grade III meningiomas between 2000 and 2018.
- Analysis of patient survival variables, including overall survival and progression-free survival.
- Statistical analysis to determine the relationship between clinical factors and outcomes.
Main Results:
- The study included 26 patients, predominantly with anaplastic meningiomas.
- Median overall survival was 2.45 years, and median progression-free survival was 1.22 years.
- Adjuvant radiotherapy improved survival in subtotal resections but not gross total resections; gross total resection showed a trend towards better survival.
Conclusions:
- WHO grade III meningiomas have a poor prognosis despite aggressive treatment.
- Adjuvant radiotherapy may not benefit patients with gross total resection of these tumors.
- Further research is needed to clarify the impact of resection extent and adjuvant therapies for aggressive meningiomas.
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