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MIB-1 index predicts low recurrence risk after subtotal resection of meningiomas: a retrospective study of 505
Laajava Joonas1, Määttä Jenni2, Korja Miikka2
1Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, Helsinki, FI-00029, Finland. joonas.laajava@helsinki.fi.
Abstract:
The Ki-67/MIB-1 index, a biomarker of cellular proliferation, holds prognostic value. In meningiomas, MIB-1 correlates with recurrence, with a proposed 4.1% cutoff. This study aimed to identify optimal patient groups for the MIB-1 proliferation index threshold, hypothesizing improved recurrence prediction within stratified subgroups. We performed a retrospective cohort study of adult patients (≥ 18 years) undergoing primary meningioma resection (2005-2018) with available MIB-1 proliferation index and at least five years of MRI follow-up. Meningiomas of all WHO grades were included. Of 505 patients (median age 59 years) meeting inclusion criteria, 340 (67.3%) were female, with meningiomas predominantly WHO grade I (55.8%) or II (41.6%). subtotally resected (STR) WHO grade I meningiomas account for a total of 58 (20.6%) cases out of all 282 (GTR + STR) surgically treated grade I meningiomas. Of these 58 STR grade I meningiomas, 21 (36%) recurred within the 5-year follow-up period. Among 35 subtotally resected grade I meningiomas with MIB-1 values of ≤ 4%, only four (11%) recurred in five years. In the multivariable analysis, preoperative meningioma volume ((p = 0.02, HR 1.02) per 1 cm3 increase) and 4% cutoff for MIB-1 ((p = 0.02, HR 3.9) remained significant with respect to 5-year recurrence. Consistent with prior studies, the MIB-1 index of 4% seems to identify a subgroup of meningioma patients with low risk of recurrence. MIB-1 is likely to offer utility especially in designing individualized and less frequent imaging follow-up strategies after resection of WHO grade I meningiomas, where molecular genetics are not defined routinely.Clinical trial number: not applicable.
Insights
The MIB-1 proliferation index helps predict meningioma recurrence. A 4% MIB-1 cutoff identifies patients with a low risk of tumor recurrence, aiding in personalized follow-up strategies.
Area of Science:
- Neuro-oncology
- Surgical Pathology
- Biomarker Research
Background:
- The Ki-67/MIB-1 index is a prognostic biomarker for cellular proliferation.
- In meningiomas, MIB-1 correlates with recurrence, with a proposed 4.1% cutoff.
- Optimal patient stratification for MIB-1 thresholds requires further investigation.
Purpose of the Study:
- To identify optimal patient groups for the MIB-1 proliferation index threshold.
- To evaluate the MIB-1 index's effectiveness in predicting meningioma recurrence within stratified subgroups.
Main Methods:
- Retrospective cohort study of adult patients (≥18 years) undergoing primary meningioma resection (2005-2018).
- Inclusion criteria: available MIB-1 index and ≥5 years of MRI follow-up.
- Analysis included meningiomas of all WHO grades, focusing on subtotally resected (STR) WHO grade I cases.
Main Results:
- Of 505 patients, 58 STR WHO grade I meningiomas were analyzed; 36% recurred within 5 years.
- Among 35 STR grade I meningiomas with MIB-1 ≤4%, only 11% recurred within 5 years.
- Multivariable analysis identified preoperative tumor volume and MIB-1 ≤4% as significant predictors of 5-year recurrence.
Conclusions:
- The MIB-1 index, particularly at a 4% cutoff, identifies a subgroup of meningioma patients with a low risk of recurrence.
- MIB-1 utility is significant for designing individualized imaging follow-up strategies for WHO grade I meningiomas.
- This biomarker aids in personalized management, especially when molecular genetics are not routinely assessed.
