Benign meningiomas (WHO Grade I) with atypical histological features: correlation of histopathological features with clinical outcomes

Abstract

OBJECT World Health Organization (WHO) Grade I (benign) meningiomas with atypical features may behave more aggressively than similarly graded tumors without atypical features. Here, the prognostic significance of atypical features in benign meningiomas was determined. METHODS Data from patients diagnosed with WHO Grade I benign meningiomas per the 2007 WHO criteria and who underwent surgery between 2002 and 2012 were retrospectively reviewed. Patients were stratified by the absence or presence of 1 to 2 atypical features with review of the clinical and histological factors. RESULTS A total of 148 patients met the inclusion criteria (n = 77 with atypia; n = 71 without atypia). The median follow-up duration after pathological diagnosis was 37.5 months. Thirty patients had progression/recurrence (P/R) after initial treatment, and 22 (73%) of 30 patients with P/R had 1-2 atypical features. The presence of atypical features was significantly associated with P/R (p = 0.03) and independent of the MIB-1 labeling index. The 1-year and 5-year actuarial rates of P/R were 9.6% versus 1.4% and 30.8% versus 13.8% fortumors with and without atypical features, respectively. Higher Simpson grade resection (II-IV vs I) was associated with the increased risk of P/R (p < 0.001). Stratification of patients into low-risk (Simpson Grade I), intermediate-risk (Simpson Grade II-IV with no atypical features), and high-risk groups (Simpson Grade II-IV with atypical features) was significantly correlated with increased risk of P/R (p < 0.001). CONCLUSIONS Patients with benign meningiomas with atypical features and those undergoing Simpson Grade II-IV resection are at significantly increased risk of P/R. Patients with these features may benefit from the consideration of additional surgery and/or radiation therapy.

Intraoperative quantification of meningioma cell proliferation potential using rapid flow cytometry reveals intratumoral heterogeneity

“…There has been recent accumulation of knowledge regarding meningiomas based on detailed radiological and pathological examinations. One discovery is that World Health Organization (WHO) Grade 1 meningiomas believed to be uniformly benign are not necessarily homogeneous in terms of postoperative behavior . Recent studies have led to the critical finding that the biological behavior of each tumor may have an equivalent or greater impact on the recurrence rate compared to that of the extent of the resection .…”

“…One discovery is that World Health Organization (WHO) Grade 1 meningiomas believed to be uniformly benign are not necessarily homogeneous in terms of postoperative behavior . Recent studies have led to the critical finding that the biological behavior of each tumor may have an equivalent or greater impact on the recurrence rate compared to that of the extent of the resection . As one indicator of biological characteristics, the MIB‐1 labeling index (LI) has prognostic value for meningioma recurrence .…”

“…Recent studies have led to the critical finding that the biological behavior of each tumor may have an equivalent or greater impact on the recurrence rate compared to that of the extent of the resection . As one indicator of biological characteristics, the MIB‐1 labeling index (LI) has prognostic value for meningioma recurrence . Tumors with an MIB‐1 LI of 3% or higher carry a significant risk of shorter recurrence‐free survival, even after gross total resection .…”

“…As one indicator of biological characteristics, the MIB‐1 labeling index (LI) has prognostic value for meningioma recurrence . Tumors with an MIB‐1 LI of 3% or higher carry a significant risk of shorter recurrence‐free survival, even after gross total resection . However, there are some operational problems regarding the utilization of MIB‐1 LI.…”

Expressão tecidual e sérica de microRNAs associados a receptores de estrógeno e progesterona em meningiomas grau I, II e III

“…Meningiomas são os tumores cerebrais primários mais comuns e representam aproximadamente 36% de todos os tumores primários do sistema nervoso central, com taxas de incidência anual de aproximadamente 4,4 a cada 100.000 indivíduos, sendo mais comum em mulheres e após a quinta década de (KRAMPLA, et al 2004, MARCISCANO, et al 2015, MAROSI et al, 2008PHAM et al, 2011, WICKREMESEKERA, et al 2010, YANO, et al 2006). Meningiomas também são os tumores cerebrais primários mais diagnosticados em adultos, sendo responsáveis por aproximadamente um terço de todos esses casos (BOSNYAK, et al 2015).…”