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Updated: Oct 25, 2025
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Published on: July 5, 2021
Treatment and follow-up results of WHO grade II meningiomas
Mustafa Güdük1, Murat Şakir Ekşi1, Baran Bozkurt1
1Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey.
Abstract:
Meningiomas are the most common primary intracranial tumors. They have three pathologic grades. Surgical resection aiming Simpson I resection is the standard treatment for meningiomas. Radiotherapy and Gamma Knife radiosurgery are the main adjuvant and salvage treatments. Chemotherapy has limited use. Grade II, and III meningiomas have a higher recurrence rate, and adjuvant radiotherapy is usually the standard treatment for grade III meningiomas but there is not a consensus regarding grade II meningiomas. In this paper, we analyzed our meningioma series of 1401 patients and presented the treatment and follow-up results of 170 grade II meningioma cases. The median follow-up of grade II meningiomas was 61 (range = 1-231) months. The mean age of patients was 52.5 ± 15.0 years, 102 of them were female and 68 were male (female/male ratio = 1.5). The median progression-free survival (PFS) of them was 109 months, and the cumulative overall survival (OS) rate was 85% at 10 years. Meningiomas with gross total resection, non-skull base meningiomas, and primary grade II meningiomas had longer PFS with statistical significance, while non-skull base meningiomas, younger group of patients, and primary grade II meningiomas had longer OS with a statistical significance.
Insights
This study analyzed 170 grade II meningioma cases, finding that gross total resection and non-skull base tumors improve progression-free survival. Younger patients with non-skull base and primary grade II meningiomas also showed significantly longer overall survival.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas are the most common primary brain tumors, with varying grades and recurrence rates.
- Surgical resection is the primary treatment, with adjuvant radiotherapy for higher grades, but consensus is lacking for grade II meningiomas.
- This study focuses on treatment and outcomes for a significant cohort of grade II meningioma patients.
Purpose of the Study:
- To analyze treatment and follow-up results for 170 patients with grade II meningiomas.
- To identify factors influencing progression-free survival (PFS) and overall survival (OS) in grade II meningiomas.
- To contribute to understanding optimal management strategies for this tumor type.
Main Methods:
- Retrospective analysis of 170 grade II meningioma cases from a larger series of 1401 patients.
- Data collection included patient demographics, tumor characteristics, treatment modalities, and follow-up duration (median 61 months).
- Statistical analysis was performed to determine factors affecting PFS and OS.
Main Results:
- The median PFS was 109 months, with an 85% 10-year OS rate.
- Gross total resection, non-skull base location, and primary grade II diagnosis were associated with significantly longer PFS.
- Non-skull base location, younger patient age, and primary grade II diagnosis were significantly linked to longer OS.
Conclusions:
- Gross total resection and non-skull base tumors are favorable prognostic factors for grade II meningiomas.
- Younger age and primary diagnosis also correlate with improved long-term outcomes.
- These findings support tailored treatment approaches for grade II meningiomas based on tumor characteristics and patient factors.
