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Published on: January 14, 2014
Atypical Histological Features as Risk Factors for Recurrence in Newly Diagnosed WHO Grade I Meningioma
Keitaro Chiba1, Takashi Sugawara1, Daisuke Kobayashi2
1Department of Neurosurgery, Tokyo Medical and Dental University.
Abstract:
The significance of atypical histological features (AHF) as risk factors for recurrence in benign meningioma is not well understood. This study examined risk factors of World Health Organization (WHO) Grade I meningioma (GIM) recurrence, focusing on AHF. We investigated 150 consecutive newly diagnosed GIM patients who had more than one year of follow-up after resection in our hospital between January 2007 and March 2018. The following factors were reviewed retrospectively: age, sex, tumor location, extent of resection, MIB-1 index, mitotic figures, number and distribution of AHF, and recurrence. The patients were grouped according to the presence or absence of recurrence and comparatively examined. Recurrence was observed in 10 cases (6.7%). Univariate analysis showed that patients with recurrence had a significantly higher MIB-1 index (2.0 vs. 4.3; p = 0.006) and a significantly higher proportion of male patients (21.4% vs. 70.0%; p = 0.002) and patients with sheet-like growth (6.42% vs. 30.0%; p = 0.04). In multivariate analysis, skull base location (odds ratio [OR] 31.424; 95% confidence interval [CI] 1.74-569), gross total resection (OR 0.130; 95% CI 0.0189-0.897), and MIB-1 index (OR 1.939; 95% CI 1.19-3.15) were significantly associated with recurrence. Our study revealed that skull base location, subtotal resection, and high MIB-1 index were independent risk factors for recurrence. Only the presence of sheet-like growth had a significantly higher incidence in patients with recurrence in univariate analysis of AHF. Multivariate analysis found no significant association. Sheet-like growth may be involved in malignancy and recurrence of benign meningioma.
Insights
Atypical histological features in benign meningioma are not well understood as recurrence risk factors. This study found skull base location, subtotal resection, and high MIB-1 index predict recurrence in Grade I meningioma.
Area of Science:
- Neuropathology
- Oncology
- Surgical Oncology
Background:
- Benign meningiomas (World Health Organization Grade I) can recur, but risk factors are not fully elucidated.
- Atypical histological features (AHF) are suspected to influence recurrence risk, yet their significance remains unclear.
- Understanding recurrence predictors is crucial for optimizing patient management and follow-up strategies.
Purpose of the Study:
- To investigate the association between atypical histological features and recurrence in Grade I meningioma.
- To identify independent risk factors for recurrence in patients with newly diagnosed Grade I meningioma.
- To evaluate the role of specific AHF, such as sheet-like growth, in predicting tumor recurrence.
Main Methods:
- Retrospective review of 150 patients with newly diagnosed Grade I meningioma and over one year of follow-up.
- Analysis of clinicopathological factors including age, sex, tumor location, extent of resection, MIB-1 index, and AHF.
- Univariate and multivariate analyses to determine significant risk factors for tumor recurrence.
Main Results:
- Recurrence was observed in 6.7% of patients.
- Univariate analysis indicated higher MIB-1 index, male sex, and sheet-like growth were associated with recurrence.
- Multivariate analysis identified skull base location, gross total resection, and MIB-1 index as independent predictors of recurrence.
Conclusions:
- Skull base location, subtotal resection, and a high MIB-1 index are significant independent risk factors for Grade I meningioma recurrence.
- While sheet-like growth showed a univariate association with recurrence, it was not an independent predictor in multivariate analysis.
- Further research is needed to clarify the role of sheet-like growth and other AHF in meningioma behavior.
