Impact of Shape Irregularity in Medial Sphenoid Wing Meningiomas on Postoperative Cranial Nerve Functioning, Proliferation, and Progression-Free Survival

Abstract

Medial sphenoid wing meningiomas (MSWM) are surgically challenging skull base tumors. Irregular tumor shapes are thought to be linked to histopathology. The present study aims to investigate the impact of tumor shape on postoperative functioning, progression-free survival, and neuropathology. This monocentric study included 74 patients who underwent surgery for primary sporadic MSWM (WHO grades 1 and 2) between 2010 and 2021. Furthermore, a systematic review of the literature regarding meningioma shape and the MIB-1 index was performed. Irregular MSWM shapes were identified in 31 patients (41.9%). Multivariable analysis revealed that irregular shape was associated with postoperative cranial nerve deficits (OR: 5.75, 95% CI: 1.15–28.63, p = 0.033). In multivariable Cox regression analysis, irregular MSWM shape was independently associated with tumor progression (HR:8.0, 95% CI: 1.04–62.10, p = 0.046). Multivariable regression analysis showed that irregular shape is independently associated with an increased MIB-1 index (OR: 7.59, 95% CI: 2.04–28.25, p = 0.003). A systematic review of the literature and pooled data analysis, including the present study, showed that irregularly shaped meningiomas had an increase of 1.98 (95% CI: 1.38–2.59, p < 0.001) in the MIB-1 index. Irregular MSWM shape is independently associated with an increased risk of postoperative cranial nerve deficits and a shortened time to tumor progression. Irregular MSWM shapes might be caused by highly proliferative tumors.

Association of quantitative radiomic shape features with functional outcome after surgery for primary sporadic dorsal spinal meningiomas

“…In an analysis involving 303 patients who underwent surgical removal of non-skull or skull base meningiomas classified as WHO grades 1–3, it was revealed that decreased sphericity significantly predicted both local meningioma regrowth and survival. In a previous institutional series, we could also identify sphericity as a surrogate parameter regarding postoperative cranial nerve functioning after surgery for medial sphenoid wing meningioma ( 15 ). Furthermore, an irregular shape was found to be significantly associated with increased proliferative activity, as reflected by the MIB-1 index, in medial sphenoid wing meningiomas ( 15 ).…”

“…In a previous institutional series, we could also identify sphericity as a surrogate parameter regarding postoperative cranial nerve functioning after surgery for medial sphenoid wing meningioma ( 15 ). Furthermore, an irregular shape was found to be significantly associated with increased proliferative activity, as reflected by the MIB-1 index, in medial sphenoid wing meningiomas ( 15 ). However, in the present series, we could not observe a correlation between the shape of primary dorsal SMs and the number of mitotic figures or the MIB-1 index.…”

“…In contrast, only a limited number of studies have focused exclusively on dorsally located SMs, despite a large-scale bicentric study reported comparable postoperative functional outcomes between ventrally and dorsally located SMS ( 8 , 13 ). Recently, radiomics of the preoperative meningioma shape were observed to be significantly associated with the WHO grade of cranial meningiomas and with the postoperative cranial nerve functioning after surgery for medial sphenoid wing meningiomas ( 14 , 15 ).…”

The safety and use of perioperative dexamethasone in the perioperative management of primary sporadic supratentorial meningiomas

“…Immunohistochemical analysis was conducted on the specimen, using the Molecular Immunology Borstel-I (MIB-I, DAKO, Glostrup, Denmark) antibody for Ki67 antigen detection. The MIB-I index was determined using the average method as previously described ( 26 ).…”