Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma

Rydzewski, Nicholas R.; Lesniak, Maciej S.; Chandler, James P.; Kalapurakal, John A.; Pollom, Erqi L.; Tate, Matthew C.; Bloch, Orin; Kruser, Tim J.; Dalal, Prarthana; Sachdev, Sean

doi:10.1002/cncr.31088

Cited by 82 publications

(74 citation statements)

References 34 publications

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Section: Introductionmentioning

confidence: 99%

“…Meningiomas are non-glial, and extra-axial neoplasms, arising from arachnoid caps cells (1)(2)(3). The World Health Organization (WHO) classi cation of central nervous system tumors strati es meningiomas in three major groups, re ected by the WHO grades I (benign), II (atypical), and III (malignant) (1)(2)(3). The majority of meningiomas are low-grade (benign) with only 10% classi ed as high-grade neoplasms, atypical and malignant meningiomas, accounting for 5-7%, and 1-3%, respectively, of all meningiomas (2).…”

Section: Introductionmentioning

confidence: 99%

“…The majority of meningiomas are low-grade (benign) with only 10% classi ed as high-grade neoplasms, atypical and malignant meningiomas, accounting for 5-7%, and 1-3%, respectively, of all meningiomas (2). The ve-year overall survival rate is 85.5% for benign lesions, 75.9% for atypical lesions, and 55.4% for malignant lesions (3). Surgery is the mainstay curative treatment for low-grade meningiomas (1-3).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, surgery alone is insu cient (1,2). Recent studies have suggested that immediate, adjuvant RT appears to be strongly associated with improved survival rate of high-grade meningiomas (2,3). CRN is the most relevant side effect after RT and can masquerade as tumor recurrence (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Radiation Necrosis Masquerading as Recurrent, High-Grade Meningioma: A Case Report

AlQooti¹,

Luther²,

Shah³

et al. 2020

Preprint

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Background: Cerebral radiation necrosis (CRN) is a complication caused by radiation therapy (RT) used for treating high-grade intracranial neoplasms. It is essential to be aware of this condition as it can be frequently mistaken for tumor recurrence. Herein, we report a case of misdiagnosis of CRN in a young male, which has heavily influenced his clinical history.Case Presentation: We report a 25-year-old male diagnosed with right frontal convexity meningioma based on computerized tomography (CT)/magnetic resonance imaging (MRI). The operation achieved a macroscopically complete tumor resection. The histopathology was an atypical meningioma. Accordingly, the patient received RT. The patient reported new-onset of generalized seizures and worsening of left hemiparesis three months after completion of RT. MRI showed abnormal peripheral enhancement in the right frontal region involving the genu of the corpus callosum and extensive brain edema. Magnetic resonance spectrometry (MRS) changes were suggestive of tumor recurrence. The patient underwent surgery with total resection of the lesion. The histopathology was CRN without evidence of tumor recurrence. Due to refractory progressive brain edema, the patient’s clinical status deteriorated until he expired.Conclusion: CRN carries morbidity and mortality as a complication from brain irradiation. There is no single modality that can reliably distinguish CRN from recurrent tumor. Therefore, a multimodality approach highly recommended.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Radiation Necrosis Masquerading as Recurrent, High-Grade Meningioma: A Case Report

AlQooti¹,

Luther²,

Shah³

et al. 2020

Preprint

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“…Or why awake surgery enthusiasts reach different conclusions in systematic reviews on the impact of awake surgery than others [4,14]? Or is this why radiotherapy usually reduces recurrence rates in atypical meningioma if studies are done by radiation oncologists [18,[20][21][22] but not necessarily if the studies are done by neurosurgeons [7,13,15,17]?…”

mentioning

confidence: 99%

Are other scientific genealogies reporting alternative facts?

Solheim

2019

Acta Neurochir

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Glioblastoma and Other Primary Brain Malignancies in Adults

Schaff

Mellinghoff

2023

JAMA

279

118

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ImportanceMalignant primary brain tumors cause more than 15 000 deaths per year in the United States. The annual incidence of primary malignant brain tumors is approximately 7 per 100 000 individuals and increases with age. Five-year survival is approximately 36%.ObservationsApproximately 49% of malignant brain tumors are glioblastomas, and 30% are diffusely infiltrating lower-grade gliomas. Other malignant brain tumors include primary central nervous system (CNS) lymphoma (7%) and malignant forms of ependymomas (3%) and meningiomas (2%). Symptoms of malignant brain tumors include headache (50%), seizures (20%-50%), neurocognitive impairment (30%-40%), and focal neurologic deficits (10%-40%). Magnetic resonance imaging before and after a gadolinium-based contrast agent is the preferred imaging modality for evaluating brain tumors. Diagnosis requires tumor biopsy with consideration of histopathological and molecular characteristics. Treatment varies by tumor type and often includes a combination of surgery, chemotherapy, and radiation. For patients with glioblastoma, the combination of temozolomide with radiotherapy improved survival when compared with radiotherapy alone (2-year survival, 27.2% vs 10.9%; 5-year survival, 9.8% vs 1.9%; hazard ratio [HR], 0.6 [95% CI, 0.5-0.7]; P &lt; .001). In patients with anaplastic oligodendroglial tumors with 1p/19q codeletion, probable 20-year overall survival following radiotherapy without vs with the combination of procarbazine, lomustine, and vincristine was 13.6% vs 37.1% (80 patients; HR, 0.60 [95% CI, 0.35-1.03]; P = .06) in the EORTC 26951 trial and 14.9% vs 37% in the RTOG 9402 trial (125 patients; HR, 0.61 [95% CI, 0.40-0.94]; P = .02). Treatment of primary CNS lymphoma includes high-dose methotrexate-containing regimens, followed by consolidation therapy with myeloablative chemotherapy and autologous stem cell rescue, nonmyeloablative chemotherapy regimens, or whole brain radiation.Conclusions and RelevanceThe incidence of primary malignant brain tumors is approximately 7 per 100 000 individuals, and approximately 49% of primary malignant brain tumors are glioblastomas. Most patients die from progressive disease. First-line therapy for glioblastoma is surgery followed by radiation and the alkylating chemotherapeutic agent temozolomide.

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Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma

Abstract: GTR and adjuvant RT appear to be highly associated with improved survival, independent of other factors, in patients with atypical meningiomas. Cancer 2018;124:734-42. © 2017 American Cancer Society.

Cited by 82 publications

References 34 publications

Cerebral Radiation Necrosis Masquerading as Recurrent, High-Grade Meningioma: A Case Report

Cerebral Radiation Necrosis Masquerading as Recurrent, High-Grade Meningioma: A Case Report

Are other scientific genealogies reporting alternative facts?

Glioblastoma and Other Primary Brain Malignancies in Adults

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