Time to Recurrence of Intracranial Meningiomas from a Monoinstitutional Surgical Series

Francesco Maiuri ¹, Sergio Corvino ¹, Giuseppe Corazzelli ¹

⁰Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, Naples, Italy.

World Neurosurgery +

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February 28, 2024

View abstract on PubMed

Summary

Complete resection and low Ki67-MIB1 levels are key to longer meningioma recurrence times. Patients with incomplete resection or high Ki67-MIB1 need closer follow-up after surgery.

Area Of Science

Neurosurgery
Oncology
Pathology

Background

Meningiomas exhibit varied recurrence tendencies, with limited data on recurrence timing.
Understanding factors influencing time to recurrence is crucial for preoperative decision-making and tailored follow-up strategies.

Purpose Of The Study

To identify key factors influencing the time to recurrence in intracranial meningiomas.
To aid in preoperative treatment planning and establish personalized clinical and neuroradiological follow-up protocols.

Main Methods

Retrospective review of 35 patients with intracranial meningioma recurrences.
Analysis of demographic, radiologic, pathologic (WHO grade, Ki67-MIB1, progesterone receptor [PR] expression), and surgical (Simpson grade extent of resection) factors.
Statistical analysis to determine correlations between factors and time to recurrence.

Main Results

Time to recurrence varied from 20 to 120 months.
Longer recurrence times were associated with skull base localization, Simpson grades I/II resection, Ki67-MIB1 ≤ 4%, and PR > 60%.
Sex, age, number of reoperations, and changes in WHO grade or Ki67 did not significantly correlate with recurrence time.

Conclusions

Extent of resection (Simpson grades I/II) and low Ki67-MIB1 values are the most significant predictors of longer recurrence-free survival.
Incomplete resection (Simpson grades III/IV) and high Ki67-MIB1 levels, particularly in non-skull base meningiomas with low PR expression, necessitate intensified short-term follow-up.
These findings support personalized follow-up schedules based on histopathological and surgical factors.

Keywords:

Extent of resection Intracranial meningiomas Ki67 Prognostic factors Time to recurrence WHO grade