Preoperative and Histological Predictors of Recurrence and Survival in Atypical Meningioma After Initial Gross Total Resection

Loewenstern, Joshua; Shuman, William H; Rutland, John W; Kessler, Remi A.; Kohli, Karan; Umphlett, Melissa; Pain, Margaret; Bederson, Joshua B.; Fowkes, Mary; Shrivastava, Raj

doi:10.1016/j.wneu.2019.04.069

Cited by 21 publications

(27 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, grading does not always provide reliable information about tumor recurrence and aggressive behavior (14). In the study of Loewenstern et al (15), they said that high-grade meningiomas may recur even after gross total resection. They also found that a high mitotic index was associated with recurrence and mortality.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of meningioma and alternative method of grading

Sayğın¹

2020

Erciyes Med J

View full text Add to dashboard Cite

Objective: The current classification of meningioma is based on the mitotic count, brain invasion and atypical histological changes. We re-evaluated the cases of meningioma to make accurate grading and to investigate the effects of morphological parameters and their relationship with each other. We discussed the counting method of mitotic activity. We tried to develop a novel method to determine the most accurate grade. Materials and Methods: In this study, three hundred nine cases of meningioma were re-evaluated. The number of mitosis in 10 consecutive high-power fields, as well as the total number of mitosis in 1 cm 2 area, was found for all cases. Receiver Operating Characteristics curve analysis was performed on the mitotic counts of 304 cases (grade I and II) in both 10 consecutive high-power fields and 1 cm 2 for predicting the grade. Results: In Receiver Operating Characteristics curve analysis, the number of mitoses determining grade II with 99% specificity and 84.4% sensitivity in 1 cm2 was 7 or more. Receiver Operating Characteristics curve analysis for the mitotic count in 10 consecutive high-power fields when the number of mitosis 4 or more, the sensitivity was 84.4%, and it was 100% specific for grade II. Conclusion: The major cause of the grade change was the number of mitotic activities. We recommend that the mitotic activity count in a large area. Especially, if there is 7 or more mitosis in 1 cm 2 , the case is to be high-grade. On the other hand, the presence of 1 or more mitosis in 42 high-power fields supports that this case is more likely to be grade II.

show abstract

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of meningioma and alternative method of grading

Sayğın¹

2020

Erciyes Med J

View full text Add to dashboard Cite

show abstract

“…AM criteria increased the mitotic activity, histological brain invasion, or at least three of the following features: increased cellularity, small cells with high nuclear-to-cytoplasmic ratio, prominent nucleoli, sheeting, and foci of spontaneous necrosis (31). Several studies revealed that increased mitotic activity is accepted as 4-19 mitoses per 10 high-power field (HPF) (5,8,11,22,34). In the 2016 WHO classification, brain invasion was included as an independent histological criterion to diagnose AM (5,8).…”

Section: Pinar Karabaglimentioning

confidence: 99%

“…Organization (WHO) classifies meningiomas into three main groups according to their biological behavior and grades: benign (grade I), atypical (grade II), and anaplastic (grade III) meningiomas (8,20,31,34). Compared with benign meningioma, atypical meningiomas (AMs) are more aggressive and have been associated with more rapid disease progression and morbidity (11,22). █…”

mentioning

confidence: 99%

Histopathological and clinical features as prognostic factors of atypical meningiomas

Karabağlı

Karabağlı²,

Mavi³

et al. 2020

Turkish Neurosurgery

View full text Add to dashboard Cite

AIM:To analyze the correlation of clinicopathologic prognostic parameters with atypical meningiomas (AMs) and recurrence development as well as progression-free survival (PFS). MATERIAL and METHODS:The neuropathology archive and hospital records of 75 patients with AM who underwent surgery in our institution between 2010 and 2019 were retrospectively reviewed. The pathological revision was performed according to the 2016 World Health Organization (WHO) criteria. Other clinicopathological parameters, such as age, gender, tumor location, preoperative tumor size, degree of resection, Psammoma body, nuclear atypia, main histological pattern, Ki67 labeling index (LI), radiotherapy, and dura and bone invasion, were also analyzed. Statistically, univariate and multivariate analyses were assessed to determine their potential impact on recurrence-related prognostic factors. RESULTS:Recurrence occurred in 20 patients. The mean PFS and follow-up time were 38.9 and 44.8 months, respectively. In univariate analysis, clinical and pathological features such as age of ≤55 years, female sex, skull base tumor location, larger preoperative tumor size, increased mitotic count, small cells, hypercellularity, sheeting, necrosis, and dura and bone invasion were remarkable in patients with recurrence, but were not statistically significant. In multivariate analysis, increased mitotic activity and brain invasion either considered alone or combined were significantly associated with PFS. Nuclear atypia was also not associated with both tumor recurrence and PFS. However, clinical features did not significantly influence the PFS. CONCLUSION:This study found that recurrence could not be predicted by the presence of any of the clinicopathological features of AMs. We believe that molecular variables determined through routine neuropathological analysis will be needed in the future.

show abstract

“…As the extent of resection is the most important prognostic factor in case of chordoid meningioma treatment, Gross total resection (GTR) should be the goal for the surgical management of primary chordoid meningioma. It remains the strongest predictor of long-term rates of tumor control [4][5][6][7][8][9][15][16][17][18][19][20]. As the recurrence remains high following subtotal resection, careful follow up should be recommended in every case.…”

Section: Microscopic Examinationmentioning

confidence: 99%

“…The most illustrative reason for careful observation was presented by Couce, et al [5]. In his long term follow up, all patients after a subtotal resection experienced tumor recurrence, while only 1 out of the 29 patients after mitotic rate, increased cellularity, small cell change, sheet like growth, macro nucleoli and focal necrosis are present [3,9]. Loewenstern, et al [9] noticed moreover, that the mitotic index is a direct indicator of cell proliferation and predictor of tumor behavior.…”

Section: Microscopic Examinationmentioning

confidence: 99%

Chordoid Meningioma: Case Report and Review of the Literature

Prokopienko¹,

Wierzba-Bobrowicz²,

Grajkowska³

et al. 2020

Neurosurg Cases Rev

View full text Add to dashboard Cite

Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman's syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of choroid meningioma in adult patient without Castleman's syndrome manifestation. As its chordoid features is related with a rapid recurrence after incomplete removal, meticulous histopathological examination is crucial for the adequate postoperative treatment plan.

show abstract

Preoperative and Histological Predictors of Recurrence and Survival in Atypical Meningioma After Initial Gross Total Resection

Cited by 21 publications

References 45 publications

Retrospective analysis of meningioma and alternative method of grading

Retrospective analysis of meningioma and alternative method of grading

Histopathological and clinical features as prognostic factors of atypical meningiomas

Chordoid Meningioma: Case Report and Review of the Literature

Contact Info

Product

Resources

About