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Grade 3 meningioma survival and recurrence outcomes in an international multicenter cohort
Kira Tosefsky1, Alexander D Rebchuk2, Justin Z Wang3
11MD Undergraduate Program, University of British Columbia.
Objective:
Grade 3 meningioma represents a rare meningioma subtype, for which limited natural history data are available. The objective of this study was to identify demographics and pathologic characteristics, clinical and functional status outcomes, and prognostic factors in an international cohort of grade 3 meningioma patients.
Methods:
Clinical and histopathological data were collected for patients treated at 7 sites across North America and Europe between 1991 and 2022.
Results:
A total of 103 patients (54% female, median age 65 [IQR 52, 72] years) were included. Sixty-seven (65%) patients had de novo grade 3 lesions, whereas 29 (28%) had malignant transformations of lower-grade meningiomas. All patients underwent initial resection of their tumor. Patients were followed for a median of 46 (IQR 24, 108) months, during which time there were 65 (73%) recurrences and 50 (49%) deaths. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66% (95% CI 56%-77%) and 37% (95% CI 28%-48%), respectively. Age ≥ 65 years and male sex were independent predictors of worse OS and PFS in multivariate regression analysis, while postoperative radiotherapy was independently associated with improved OS. Karnofsky Performance Status (KPS) remained stable relative to baseline over 5 years postdiagnosis among participants who were alive at the end of the follow-up period.
Conclusions:
This large multicenter study provides insight into the longitudinal outcomes of grade 3 meningioma, with respect to recurrence, survival, and functional status. This study affirms the survival benefit conferred by radiotherapy in this population and suggests good functional status outcomes for patients surviving to 5 years postoperatively.
Insights
This study on grade 3 meningioma found that older age and male sex predict worse outcomes, while radiotherapy improves survival. Functional status remains stable for long-term survivors.
Area of Science:
- Neuro-oncology
- Pathology
- Clinical Outcomes Research
Background:
- Grade 3 meningioma is rare with limited natural history data.
- Understanding its characteristics and prognosis is crucial for patient care.
Purpose of the Study:
- To identify demographics and pathological characteristics of grade 3 meningioma.
- To determine clinical and functional status outcomes.
- To identify prognostic factors in an international cohort.
Main Methods:
- Collected clinical and histopathological data from 103 patients across 7 international sites (1991-2022).
- Analyzed demographics, tumor characteristics, recurrence, survival, and functional status (Karnofsky Performance Status).
- Utilized multivariate regression to identify prognostic factors.
Main Results:
- 5-year overall survival (OS) and progression-free survival (PFS) were 66% and 37%, respectively.
- Recurrence occurred in 73% and death in 49% of patients.
- Age ≥ 65, male sex predicted worse OS/PFS; radiotherapy improved OS; KPS remained stable for survivors.
Conclusions:
- This study offers insights into longitudinal outcomes for grade 3 meningioma.
- Radiotherapy demonstrates a survival benefit in this patient population.
- Patients surviving 5 years postoperatively show good functional status.
