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Incidence, risk factors, and prognosis of meningiomas with distant metastases at presentation
Huy Gia Vuong1,2, Tam N M Ngo3, Ian F Dunn2
1Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA.
Background:
Distant metastases (DM) at presentation in meningiomas is a very rare event, and the incidence and factors predicting this are uncertain. This population-based study also aimed to investigate the prognostic implication of DM at presentation and clinical parameters to prognosticate the overall survival (OS) of meningiomas presenting with DM (M1).
Methods:
We accessed the Surveillance, Epidemiology, and End Results program to search for patients who were diagnosed with meningioma between 2004 and 2016. The log-rank test was used to compare Kaplan-Meier survival curves and multivariate Cox regression model was utilized to evaluate the prognostic parameters of meningiomas with DM at presentation.
Results:
The incidence of DM at presentation among all meningiomas was 0.18%. Clinical variables associated with this event were male gender, large tumor size, and WHO grade III. The presence of DM at diagnosis conferred a shorter survival in comparison to those without DM (HR = 2.015; 95% CI = 1.600-2.536). Older patient age, male gender, malignant histology, and the lesser extent of resection were independent prognostic factors that could negatively impact OS of M1 meningiomas. Radiotherapy and chemotherapy were not associated with an improved outcome for these patients.
Conclusion:
Our study highlighted the clinical and prognostic factors of M1 meningiomas. These data suggest that a greater extent of resection is associated with increased OS across a nationwide analysis and emphasize the need to establish the standards of care in these patients.
Insights
Distant metastases in meningiomas (M1) are rare (0.18%) and linked to male gender, large tumors, and WHO grade III. Greater resection extent improves survival for M1 meningiomas, while radiation and chemotherapy offer no benefit.
Area of Science:
- Neuro-oncology
- Cancer epidemiology
- Surgical oncology
Background:
- Distant metastases (DM) at presentation in meningiomas are rare, with uncertain incidence and predictive factors.
- Understanding these factors is crucial for prognostication and treatment strategies.
Purpose of the Study:
- To determine the incidence and clinical factors associated with distant metastases in meningiomas at presentation.
- To investigate the prognostic implications of DM and identify independent predictors of overall survival (OS) in meningiomas with DM (M1).
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) program database (2004-2016).
- Employed Kaplan-Meier survival analysis and multivariate Cox regression to assess prognostic factors for M1 meningiomas.
Main Results:
- The incidence of DM at presentation was 0.18%.
- Male gender, large tumor size, and WHO grade III were associated with DM.
- DM significantly reduced OS (HR=2.015).
- Independent negative prognostic factors for M1 OS included older age, male gender, malignant histology, and less extensive resection.
- Radiotherapy and chemotherapy did not improve outcomes.
Conclusions:
- Identified key clinical and prognostic factors for M1 meningiomas.
- Greater extent of resection is associated with improved OS in M1 meningiomas.
- Highlights the need for standardized care protocols for these rare cases.
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