Outcome and survival following primary and repeat surgery for World Health Organization Grade III meningiomas

Sughrue, Michael E.; Sanai, Nader; Shangari, Gopal; Parsa, Andrew T.; Berger, Mitchel S.; McDermott, Michael W.

doi:10.3171/2010.1.jns091114

Cited by 131 publications

(108 citation statements)

References 22 publications

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“…76 Forty-seven percent of patients experienced recurrence at a mean follow-up of 6.9 years. Their 2-, 5-, and 10-year PFS rates after primary surgery were 80%, 57%, and 40%, respectively.…”

Section: Surgerymentioning

confidence: 99%

“…Indeed, Sughrue et al actually suggested that for both primary surgery and repeat surgery, NTR may carry survival benefit over GTR. 76 Taken together, despite a clear benefit of EOR per se, retrospective data on Grade III meningiomas support a maximal but cautious resection strategy and consideration of even repeat surgery for recurrence.…”

Section: Surgerymentioning

confidence: 99%

“…11,16 Interpretation of the data on EBRT must be taken with some caution because the majority of dose-response studies were performed prior to the WHO 2000/2007 classification. Nonetheless, together with modern studies, 1,13,21,61,68,76 evidence supports the use of radiotherapy for Grade III meningiomas (EBM Level 3, Grade 1C recommendation).…”

Section: Radiotherapymentioning

confidence: 99%

“…These studies highlighted the much higher recurrence of AMs and MMs compared with Grade I tumors. Since the WHO 2000/2007 grading system was implemented, the literature on Grade III meningiomas has been sparse (Table 6), 1,21,23,61,68,76,87 and therefore management decisions must rely on research using both pre-2000 and 2000/2007 WHO grading.…”

Section: Treatment Algorithm For Amsmentioning

confidence: 99%

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An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

115

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The management of WHO Grade II “atypical” meningiomas (AMs) and Grade III “malignant” meningiomas (MMs) remains controversial and under-investigated in prospective studies. The roles of surgery, radiation therapy, radiosurgery, and chemotherapy have been incompletely delineated. This has left physicians to decipher how they should treat patients on a case-by-case basis. In this study, the authors review the English-language literature on the management and clinical outcomes associated with AMs and MMs diagnosed using the WHO 2000/2007 grading criteria. Twenty-two studies for AMs and 7 studies for MMs were examined in detail. The authors examined clinical decision points using the literature and concepts from evidence-based medicine. Acknowledging the retrospective nature of the studies concerning AM and MM, the authors did find evidence for the following clinical strategies: 1) maximal safe resection of AM and MM; 2) active surveillance after gross-total resection of AM; 3) adjuvant radiation therapy after subtotal resection of AM, especially in the absence of putative radioresistant features; and 4) adjuvant radiation therapy after resection of MM.

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“…76 Forty-seven percent of patients experienced recurrence at a mean follow-up of 6.9 years. Their 2-, 5-, and 10-year PFS rates after primary surgery were 80%, 57%, and 40%, respectively.…”

Section: Surgerymentioning

confidence: 99%

Section: Surgerymentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

Section: Treatment Algorithm For Amsmentioning

confidence: 99%

See 2 more Smart Citations

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

115

View full text Add to dashboard Cite

show abstract

“…In a large cohort study (Sughrue et al, 2010) of 63 patients with WHO grade III meningiomas, all the patients underwent post-operative radiation therapy after the primary surgery and they were followed for median time of 5 years. Fifty-eight percent of those patients who underwent a second surgery for recurrent meningioma received either 125 I brachytherapy implants or gamma-knife radiosurgery.…”

Section: Extent Of Resection and Tendency For Recurrencementioning

confidence: 99%