HISTOPATHOLOGICAL PREDICTORS AND FUNCTIONAL RECOVERY IN PATIENTS WITH INTRACRANIAL MENINGIOMAS

The aim of this study was to investigate the clinical, morphological, and functional predictors of rehabilitation potential (RP) in patients following the removal of intracranial meningiomas. The primary objective was to assess the prognostic significance of tumor biomarkers (Ki-67, CD34), the depth of brain invasion, and the extent of surgical intervention in relation to functional recovery and the likelihood of recurrence. Meningiomas exhibit a wide biological spectrum that affects recurrence risk, neurological outcomes, and rehabilitation potential. In this context, a key aspect of the study was the correlation between the tumor's morphological characteristics and clinical outcomes, including changes in functional independence scales (ΔKPS, ΔFIM) and long-term recovery metrics. The data obtained are intended to optimize individualized prognosis, improve surgical planning, and enhance the post-operative rehabilitation strategy for patients with central nervous system tumors.

The study included 124 patients (mean age 49.1±7.6 years, range 32-68 years) who underwent surgical treatment for meningiomas during the period 2017-2024. The extent of resection, histological subtype, Ki-67 proliferation index, microvessel density (CD34), and postoperative clinical-functional parameters were evaluated. Functional status was assessed preoperatively and three months postoperatively using the Karnofsky Performance Scale (KPS) and the Functional Independence Measure (FIM).

Grade I tumors demonstrated significantly lower Ki-67 (2.0-2.5%) and CD34 (6-10 vessels/HPF) values compared to Grade II (7.4%) and Grade III (17.9%) tumors (p<0.001). Brain invasion ≥3 mm independently increased the risk of early recurrence (OR=3.8; p<0.001). Ki-67 >8% and CD34 >15 vessels/HPF were identified as independent predictors of recurrence (Cox regression). A high rehabilitation potential (ΔKPS ≥15 and ΔFIM ≥20) was achieved in 73% of patients with Grade I tumors versus 10% with Grade III tumors (p<0.001).

Low Ki-67 and CD34 values, combined with the absence of brain invasion, reliably predict favorable recovery and a low risk of recurrence. Aggressive morphological features necessitate early adjuvant therapy and more intensive rehabilitation interventions.