Extent of resection and survival outcomes in World Health Organization grade II meningiomas

Soni, Pranay; Davison, Mark A.; Shao, Jianning; Momin, Arbaz; Lopez, Diana; Angelov, Lilyana; Barnett, Gene H.; Lee, Joung H.; Mohammadi, Alireza; Kshettry, Varun R.; Recinos, Pablo F.

doi:10.1007/s11060-020-03632-3

Cited by 20 publications

(17 citation statements)

References 30 publications

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“…These may provide the basis for the predictive value of fibrinogen in AM recurrence. Many studies have confirmed the close relationship between extent of resection and AM recurrence (10,29,30). In our study, we also found that AM patients with incomplete resection (Simpson grades III-IV) had a higher risk of recurrence.…”

Section: Discussionsupporting

confidence: 86%

Establishment and Validation of an Integrated Model to Predict Postoperative Recurrence in Patients With Atypical Meningioma

Chen

Huang

et al. 2021

Front. Oncol.

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BackgroundThis study aims to establish an integrated model based on clinical, laboratory, radiological, and pathological factors to predict the postoperative recurrence of atypical meningioma (AM).Materials and MethodsA retrospective study of 183 patients with AM was conducted. Patients were randomly divided into a training cohort (n = 128) and an external validation cohort (n = 55). Univariable and multivariable Cox regression analyses, the least absolute shrinkage and selection operator (LASSO) regression analysis, time-dependent receiver operating characteristic (ROC) curve analysis, and evaluation of clinical usage were used to select variables for the final nomogram model.ResultsAfter multivariable Cox analysis, serum fibrinogen >2.95 g/L (hazard ratio (HR), 2.43; 95% confidence interval (CI), 1.05–5.63; p = 0.039), tumor located in skull base (HR, 6.59; 95% CI, 2.46-17.68; p < 0.001), Simpson grades III–IV (HR, 2.73; 95% CI, 1.01–7.34; p = 0.047), tumor diameter >4.91 cm (HR, 7.10; 95% CI, 2.52–19.95; p < 0.001), and mitotic level ≥4/high power field (HR, 2.80; 95% CI, 1.16–6.74; p = 0.021) were independently associated with AM recurrence. Mitotic level was excluded after LASSO analysis, and it did not improve the predictive performance and clinical usage of the model. Therefore, the other four factors were integrated into the nomogram model, which showed good discrimination abilities in training cohort (C-index, 0.822; 95% CI, 0.759–0.885) and validation cohort (C-index, 0.817; 95% CI, 0.716–0.918) and good match between the predicted and observed probability of recurrence-free survival.ConclusionOur study established an integrated model to predict the postoperative recurrence of AM.

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Section: Discussionsupporting

confidence: 86%

Establishment and Validation of an Integrated Model to Predict Postoperative Recurrence in Patients With Atypical Meningioma

Chen

Huang

et al. 2021

Front. Oncol.

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“…Several different prognosticators, namely, clinicalradiological, surgical or pathological characteristics have been investigated; however, no reliable consistent factors could be identified (24)(25)(26)(27)(28)(29)(30)(31). Additionally, genetic analyses have revealed some data on mutations associated with the WHO grade in recent years but similarly to the aforementioned aspects, no clearly reliable indicators were detected (12,(32)(33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

DNA Methylation Associates With Clinical Courses of Atypical Meningiomas: A Matched Case–Control Study

et al. 2022

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BackgroundAccounting for 15–20% of all meningiomas, WHO grade II meningiomas represent an intermediate group regarding risk of tumor recurrence. However, even within this subgroup varying clinical courses are observed with potential occurrence of multiple recurrences. Recently, DNA methylation profiles showed their value for distinguishing biological behaviors in meningiomas. Therefore, aim of this study was to investigate DNA methylation profiles in WHO grade II meningiomas.MethodsAll patients that underwent resection of WHO grade II meningiomas between 1993 and 2015 were screened for a dismal course clinical course with ≥2 recurrences. These were matched to control cases with benign clinical courses without tumor recurrence. DNA methylation was assessed using the Infinium Methylation EPIC BeadChip microarray. Unsupervised hierarchical clustering was performed for identification of DNA methylation profiles associated with such a dismal clinical course.ResultsOverall, 11 patients with WHO grade II meningiomas with ≥2 recurrences (Group dismal) and matched 11 patients without tumor recurrence (Group benign) were identified. DNA methylation profiles revealed 3 clusters—one comprising only patients of group dismal, a second cluster comprising mainly patients from group benign and a third cluster comprising one group dismal and one group benign patient. Based on differential methylation pattern associations with the Wnt and the related cadherin signaling pathway was observed.ConclusionDNA methylation clustering showed remarkable differences between two matched subgroups of WHO grade II meningiomas. Thus, DNA methylation profiles may have the potential to support prognostic considerations regarding meningioma recurrence and radiotherapeutic treatment allocation after surgical resection.

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“…While most dramatic in non-benign meningiomas, it remains significant in grade 1 pathology as well (58). Extent of resection affects progression free and overall survival in atypical meningiomas (59). Patients with atypical meningiomas have 5-year survival of 91.3% and 78.2% with gross total resection and non-gross total resection, respectively.…”

Section: Current Treatment Modalitiesmentioning

confidence: 99%

Molecular determinants of outcomes in meningiomas

et al. 2022

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Meningiomas are the most common intracranial primary tumor in adults. Surgery is the predominant therapeutic modality for symptomatic meningiomas. Although the majority of meningiomas are benign, there exists a subset of meningiomas that are clinically aggressive. Recent advances in genetics and epigenetics have uncovered molecular alterations that drive tumor meningioma biology with prognostic and therapeutic implications. In this review, we will discuss the advances on molecular determinants of therapeutic response in meningiomas to date and discuss findings of targeted therapies in meningiomas.

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Extent of resection and survival outcomes in World Health Organization grade II meningiomas

Cited by 20 publications

References 30 publications

Establishment and Validation of an Integrated Model to Predict Postoperative Recurrence in Patients With Atypical Meningioma

Establishment and Validation of an Integrated Model to Predict Postoperative Recurrence in Patients With Atypical Meningioma

DNA Methylation Associates With Clinical Courses of Atypical Meningiomas: A Matched Case–Control Study

Molecular determinants of outcomes in meningiomas

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