The effect of the revised WHO classification on the incidence of grade II meningioma

Bulleid, Lindsey; James, Zoe; Lammie, Alistair; Hayhurst, Caroline; Leach, Philip

doi:10.1080/02688697.2019.1639616

Cited by 14 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, on analysis of basic demographics, patients with grade 2 histology were significantly more likely to be male and have tumours larger than 6cm. Increasing proportions of male sex with higher grade meningiomas has also been reported previously when non skull base meningiomas were included (6). Cornelius et al (2013) reported male sex as an independent risk factor for higher grade meningiomas (16), however this significance was lost on binary logistic regression analysis.…”

Section: Discussionsupporting

confidence: 69%

“…Grade 2 meningiomas represented 20% of skull base meningiomas in our series. This is higher than earlier reported rates of 4-15% for all meningiomas prior to the change in histological classification in 2016 to include brain invasion (2,3,6). In a large retrospective study by Mansouri et al (2016) of 398 meningiomas, 11.6% of skull base tumours were grade 2 and 23.4% of non-skull base tumours were grade 2 (13).…”

Section: Discussionmentioning

confidence: 62%

See 1 more Smart Citation

De Novo Skull Base Atypical Meningioma: Incidence and Outcome

James

Makwana

Hayhurst

2022

J Neurol Surg B Skull Base

Self Cite

View full text Add to dashboard Cite

Aim: Atypical meningiomas are uncommon in skull base practice and present a management challenge. We aimed to review all de novo atypical skull base meningioma within a single unit to analyse presentation and outcome. Methods: A retrospective review of all patients undergoing surgery for intracranial meningioma identified consecutive cases of de novo atypical skull base meningioma. Electronic case records were analysed for patient demographics, tumour location and size, extent of resection and outcome. Tumour grading is based on the 2016 WHO criteria. Results: 18 patients with de novo atypical skull base meningiomas were identified. The most common tumour location was sphenoid wing in 10 patients (56%). Gross total resection (GTR) was achieved in 13 patients (72%) and subtotal resection (STR) in 5 patients (28%). There was no tumour recurrence recorded in patients who had undergone GTR. Patients with tumours >6cm were more likely to undergo a STR as opposed to a GTR (p=<0.01). Patients who had undergone a STR were more likely have post-operative tumour progression and be referred for radiotherapy (p=0.02 and p=<0.01 respectively). On multiple regression analysis tumour size is the only significant factor correlating with overall survival (p=0.048). Conclusion: The incidence of de novo atypical skull base meningioma is higher in our series than currently published data. Tumour size was a significant indicator for patient outcome and extent of resection. Those undergoing a STR were more likely to have tumour recurrence. Multicentre studies of skull base meningiomas with associated molecular genetics are needed to guide management.

show abstract

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 62%

De Novo Skull Base Atypical Meningioma: Incidence and Outcome

James

Makwana

Hayhurst

2022

J Neurol Surg B Skull Base

Self Cite

View full text Add to dashboard Cite

show abstract

“…The histological heterogeneity of meningiomas was first recognized by Cushing [6], and meningioma has been subject to several histological classifications and re-classifications over the years. Depending on the classification used, institution tradition, and a lag-time to implementation [15], the incidence of atypical meningioma range from 5 to 35% [4]. The later reclassifications of meningiomas have led to a substantial increase in the prevalence of atypical meningioma [20,26].…”

Section: Discussionmentioning

confidence: 99%

The impact of authors’ medical specialty on publication patterns and published results of adjuvant radiotherapy for WHO grade 2 meningiomas—a systematic review

Strand

Solheim

2021

Acta Neurochir

View full text Add to dashboard Cite

Background The role of adjuvant radiotherapy after gross total resection (GTR) of WHO grade 2 meningioma remains unclear, and conflicting results have been published. We hypothesized that authors’ medical specialties could be associated with reported findings on the role of adjuvant radiotherapy after GTR of WHO grade 2 meningiomas. Method A systematic review was conducted in Embase and Medline databases, in addition to screening of all relevant bibliographies. Articles including patients aged 18 years or older, with histologically confirmed WHO grade 2 meningioma, were included. We extracted data on medical subspecialties using the author list. We registered study design, median follow-up, number of included patients, WHO classification in use, and years of study inclusion. Results Thirty-seven relevant studies were identified, where 34 (92%) were retrospective cohort studies, two studies (5%) were systematic reviews, and one study (3%) was a meta-analysis. If the last author was a radiation-oncologist, the study was more likely to favor adjuvant radiotherapy, and if a neurosurgeon was last author, the study was more likely to not advocate adjuvant radiotherapy (p=0.009). There was no significant association between study result and whether the study was published in a neurosurgical or oncological journal (p=0.802). There was no significant difference in follow-up time, years of inclusion, or number of included patients between studies favoring or not favoring adjuvant radiotherapy. Conclusions In this systematic review of the literature, we found that if a radiation-oncologist was the last author of the study, the study was more likely to favor adjuvant radiotherapy after gross total resection of WHO grade 2 meningioma. Clinicians and researchers should be aware of a possible genealogy bias in the neuro-oncological literature.

show abstract

“…Since the implementation of the 2007 World Health Organization (WHO) grading classification, the first to consider brain invasion as a diagnostic criterion of atypical meningioma (AM), the proportion of AM in newly diagnosed meningioma has increased from less than 10% to approximately 20–35% [ 1 – 5 ]. Traditionally, maximal surgical resection has been considered as the most important factor for predicting the prognosis of AM.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant radiotherapy versus observation following gross total resection for atypical meningioma: a systematic review and meta-analysis

Chun

Kim

et al. 2021

Radiat Oncol

View full text Add to dashboard Cite

Background The impact of adjuvant radiotherapy (RT) on atypical meningioma (AM) underwent a gross total resection (GTR) remains unclear, showing conflicting results from various studies. The objective of this study was to perform an updated meta-analysis for observational studies to determine the effect of adjuvant RT after GTR on local recurrence and survival outcomes compared to observation after GTR. Methods PubMed, Embase, and Web of Science were searched to identify comparative studies that reported outcomes of adjuvant RT versus observation for AM patients after GTR. Local recurrence rate, progression-free survival (PFS), overall survival (OS), and toxicities related to RT were considered as outcomes of interest. Differences between two cohorts were estimated by calculating odds ratios (OR) for LR rate and hazard ratios (HR) for survival outcomes with 95% confidence intervals (CIs) for meta-analysis, using R version 4.0.3 software. Included studies were appraised with the Risk of Bias Assessment tool for Non-Randomized Studies. Outcome ratios were combined with the Mantel–Haenszel method and the inverse variance-weighted method, appropriately. Results Data from 30 studies involving 2904 patients (adjuvant RT: n = 737; observation: n = 2167) were eventually included. Significant reduction of local recurrence rate was seen in the adjuvant RT cohort compare to that in the observation cohort (OR 0.50; 95% CI 0.36–0.68; p < 0.0001). Pooled HRs of PFS at 1-year, 3-year, 5-year, and > 5-year revealed that adjuvant RT was superior to observation. There was no significant difference in OS between the two cohorts during any period. Most toxicities were tolerable with grade 1 or 2. There was no documented grade 5 toxicity. Conclusions For AM patients who underwent GTR, evidence suggested that adjuvant RT could potentially decrease local recurrence and improve PFS better than observation.

show abstract

The effect of the revised WHO classification on the incidence of grade II meningioma

Cited by 14 publications

References 13 publications

De Novo Skull Base Atypical Meningioma: Incidence and Outcome

De Novo Skull Base Atypical Meningioma: Incidence and Outcome

The impact of authors’ medical specialty on publication patterns and published results of adjuvant radiotherapy for WHO grade 2 meningiomas—a systematic review

Adjuvant radiotherapy versus observation following gross total resection for atypical meningioma: a systematic review and meta-analysis

Contact Info

Product

Resources

About