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Predictive Power of MIB-1 vs. Mitotic Count on Progression-Free Survival in Skull-Base Meningioma
Tim Lampmann1, Johannes Wach1, Marie-Therese Schmitz2
1Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany.
Abstract:
Although meningiomas are mainly non-aggressive and slow-growing tumors, there is a remarkable recurrence rate in a long-term follow-up. Proliferative activity and progression-free survival (PFS) differs significantly among the anatomic location of meningiomas. The aim of the present study was to investigate the predictive power of MIB-1 labeling index and mitotic count (MC) regarding the probability of PFS in the subgroup of skull-base meningiomas. A total of 145 patients were included in this retrospective study. Histopathological examinations and follow-up data were collected. Ideal cut-off values for MIB-1 and MC were ≥4.75 and ≥6.5, respectively. MIB-1 as well as MC were good predictors for PFS in skull-base meningiomas. Time-dependent analysis of MIB-1 and MC in prediction of recurrence of skull-base meningioma showed that their prognostic values were comparable, but different cut-offs for MC should be considered regarding the meningioma's location. As the achievement of a gross total resection can be more challenging in skull-base meningiomas and second surgery implies a higher risk profile, the recurrence risk could be stratified according to these findings and guide decision-making for follow-ups vs. adjuvant therapies.
Insights
MIB-1 labeling index and mitotic count predict recurrence in skull-base meningiomas. These markers help stratify recurrence risk, guiding treatment decisions for better patient outcomes.
Area of Science:
- Neurosurgery
- Pathology
- Oncology
Background:
- Meningiomas, typically slow-growing, have significant long-term recurrence rates.
- Progression-free survival (PFS) varies with tumor location.
- Skull-base meningiomas present unique surgical challenges and recurrence risks.
Purpose of the Study:
- To evaluate the predictive value of MIB-1 labeling index and mitotic count (MC) for PFS in skull-base meningiomas.
- To determine ideal cut-off values for MIB-1 and MC in this specific patient subgroup.
- To inform clinical decision-making regarding follow-up and adjuvant therapies.
Main Methods:
- Retrospective study of 145 patients with skull-base meningiomas.
- Histopathological examination including MIB-1 labeling index and MC.
- Analysis of progression-free survival (PFS) and time-dependent recurrence prediction.
Main Results:
- Identified ideal cut-off values: MIB-1 ≥4.75 and MC ≥6.5.
- Both MIB-1 and MC demonstrated significant predictive power for PFS.
- Prognostic values of MIB-1 and MC were comparable, with location-specific MC cut-offs suggested.
Conclusions:
- MIB-1 labeling index and mitotic count are valuable prognostic markers for skull-base meningiomas.
- Stratifying recurrence risk aids in personalized follow-up and treatment strategies.
- Findings support informed clinical decision-making for managing skull-base meningioma recurrence.
