Clinical features and treatment of intracranial chordoid meningioma: a report of 30 cases

Wu, Xiaoqiang; Mei, Guanghai; Zhao, Lin; Li, Shiting; Gong, Yi; Zhong, Jun; Chen, Hong; Jiang, Chengchuan

doi:10.1111/his.12113

Cited by 22 publications

(62 citation statements)

References 46 publications

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“…Our review of literature corroborates the relationship between EOR and local tumor control in the surgical management of CMs as previously reported. [2, 3, 6, 7, 18-20] While the majority of reports were single case studies and small retrospective series, our systematic review demonstrates that GTR results in better rates of long term tumor control (5- and 10-year PFS of 80.2 and 70.3%, respectively). Thus, GTR is the goal for the surgical management of primary CMs and remains the strongest predictor of long term rates of tumor progression.…”

Section: Discussionmentioning

confidence: 81%

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Predictors of recurrence in the management of chordoid meningioma

et al. 2015

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Introduction Management of chordoid meningiomas (CMs) is complicated by high rates of recurrence, particularly following subtotal resection. Optimal management is not established given the paucity of published experience. To identify prognostic factors for recurrence following resection, the authors conducted the largest systematic review of CMs to date. Methods A comprehensive search on MEDLINE (OVID and Pubmed), Scopus, Embase, and Web of Science utilizing the search terms “chordoid” AND “meningioma” was performed to identify all reports of pathologically confirmed intracranial CMs. Results A total of 221 patients were included, comprising 120 females and 101 males. Mean age, MIB-1/Ki67, and tumor size was 45.5 years, 4.3% (range:0.1-26.6%), and 4.1 cm (range: 0.8-10 cm), respectively. 5-, and 10- year progression free survival (PFS) was 67.5%, and 54.4%, respectively. Gross total resection (GTR) and subtotal resection (STR) was achieved in 172 and 48 patients, respectively. Adjuvant radiotherapy (RT) was given to 30 patients. Multivariate analysis found GTR was strongly correlated with decreased recurrence rates (HR 0.04, p =<0.0001), while higher MIB-1 labeling index (≥5% vs <5%) was associated with increased recurrence (HR 7.08; p=0.016). Adjuvant RT, age, gender, and tumor location were not associated with recurrence. Conclusion GTR resection is the strongest predictor of tumor control, and should be the goal to minimize local progression. Additionally, higher MIB-1 labeling was associated with increased rates of tumor recurrence. Tumors that are subtotally resected or demonstrate higher MIB-1 are at greater recurrence and warrant consideration for RT and close long term follow up.

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Section: Discussionmentioning

confidence: 81%

“…[6-9] Nine patients died from progression of disease and continued recurrence. [2, 7, 8, 10-15] The remaining 3 patients died from causes unrelated to disease. [6, 16, 17]…”

Section: Resultsmentioning

confidence: 99%

Predictors of recurrence in the management of chordoid meningioma

et al. 2015

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“…Moreover, a higher MIB-1 labeling index is related to meningioma recurrence5,21,24,26). However, other studies have refuted these relationships between MIB-1 labeling index and the clinical features of meningiomas11,23,25). In this series, the average MIB-1 labeling index in cases with recurrence was higher than cases without recurrence, but failed to reach statistical significance.…”

Section: Discussionmentioning

confidence: 55%

“…Because of its rarity, in patients with CM, clinical experience with adjuvant radiation therapy has not yet been accumulated. Recently, Wang et al25) reported on the benefits of adjuvant radiation therapy after incomplete CM resection. Our results support adjuvant radiation therapy in cases of incomplete resection.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Features and Treatment Outcome of Chordoid Meningiomas in a Single Institute

Jee

Seol

et al. 2014

J Korean Neurosurg Soc

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ObjectiveMeningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma.MethodsIn total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3-170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04).ResultsSimpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6-71.3) by the log-rank test (p<0.05).ConclusionChordoid meningiomas are difficult to manage and have a high rate of recurrence. Complete resection of the tumor is a key determinant of better outcomes. Adjuvant radiation therapy is recommended, eparticulary when Simpson grade I resection was not achieved.

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