Radiological Predictive Factors for Regrowth of Residual Benign Meningiomas

Abstract

The pre-and postoperative radiological predictive factors for the regrowth of residual benign meningiomas were investigated in 80 of 327 patients who underwent first surgery for intracranial meningioma, who met the following conditions: residual tumor observed on postoperative imaging, follow up for more than 5 years or until regrowth of the residual tumor, histological diagnosis of World Health Organization grade I, and no additional therapy performed within 1 month after surgery. These 80 patients were divided into those with no regrowth during the follow-up period (Group A, n ＝ 54) and those with regrowth (Group B, n ＝ 26), and the clinical characteristics and pre-and postoperative imaging findings were compared. Univariate analysis of factors influencing regrowth showed 6 factors were significant: tumor size AE4 cm (p ＝ 0.043), tumor volume AE30 cm 3 (p ＝ 0.026), presence of edema (p ＝ 0.036), unclear brain-tumor interface (p º 0.001), presence of a pial-cortical blood supply (p ＝ 0.031), and residual tumor volume AE3.0 cm 3 (p º 0.001). Multivariate analysis showed only residual tumor volume AE3.0 cm 3 was significant (p ＝ 0.001). Generally, the significant imaging findings on univariate analysis suggest malignant meningioma. Similar findings may be observed even in grade I cases, and residual tumors may regrow in such cases. The possibility is particularly high if the residual tumor volume exceeds 3.0 cm 3 , so early radiotherapy should be performed to prevent regrowth.

Predicting the risk of postoperative recurrence and high-grade histology in patients with intracranial meningiomas using routine preoperative MRI

“…Consistent with the findings in the previous smaller series, tumor volume [ 2 , 4 , 11 , 21 ], disruption of the arachnoid layer [ 4 , 11 , 21 ], and an irregular tumor shape [ 11 , 15 , 16 , 21 ] were associated with an increased risk of recurrence , while heterogeneous contrast enhancement was mostly not correlated with prognosis [ 10 , 15 , 16 ]. However, odds ratio of the tumor volume and the sensitivity and specificity were found to be low, indicating its limited value for predicting tumor recurrence.…”

A Novel MRI-Based Risk Stratification Algorithm for Predicting Postoperative Recurrence of Meningioma: More Benefits to Patients

“…Our results indicated significant differences in tumor shape and volume between the recurrent and non-recurrent groups. Similarly, several researchers found that irregular tumor shape and larger tumor volumes were associated with greater proliferative potential, and active proliferation leads to increased recurrence after resection ( 4 , 6 , 15 – 17 ). In addition, we demonstrated that peritumoral brain edema (PTBE), including peritumoral edema volume and peritumoral edema index, was strongly associated with prognosis.…”

“…Although grade II/III meningiomas have more aggressive biological behavior and might exhibit faster recurrence, there are also some high grade meningiomas that biologically behave more like benign lesions by our observation ( Figure 7 ). Likewise, many studies showed that it was inadequate to predict postoperative recurrence and develop individualized treatment strategies based solely on WHO classification ( 3 , 6 , 8 , 9 , 11 – 13 , 17 ). Consequently, in this study, we established a prediction model integrating clinical data, imaging, and pathology for tumor prognosis, and explored and developed personalized treatment strategies base on this model.…”

“…There were controversial reports about the influence of sex on meningioma recurrence. Some studies revealed that male patients had a high risk of recurrence ( 11 , 12 , 33 ), while others did not ( 6 , 9 , 13 , 17 , 25 ). Although we observed a trend towards an association between preoperative SKP and recurrence, it did not reach significance.…”

Risk of tumor recurrence in intracranial meningiomas: comparative analyses of the predictive value of the postoperative tumor volume and the Simpson classification

“…Similarly, Shakir et al 35 showed that local control is strongly correlated with the postoperative tumor volume prior to adjuvant radiation in a series of 70 atypical meningiomas and delineated a critical cutoff value of approximately 9 cm 3 . Fujimoto et al, 38 however, outlined residual tumor volume of ≥ 3 cm 3 as a predictor of progression in uni-and multivariate analysis. In contrast, our group could not determine a prognostic impact of the postoperative tumor volume in 49 subtotally (Simpson grade ≥ IV) resected skull base meningiomas in a previous study.…”