WHO grade II and III meningiomas: a study of prognostic factors

Durand, Anne; Labrousse, François; Jouvet, Anne; Bauchet, Luc; Kalamaridès, Michel; Menei, Philippe; Deruty, R; Moreau, Jean Jacques; Fèvre‐Montange, Michelle; Guyotat, Jacques

doi:10.1007/s11060-009-9934-0

Cited by 288 publications

(193 citation statements)

References 27 publications

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“…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: 87%

“…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%

“…Durand et al and Adeberg et al independently demonstrated no association between EOR and outcome. 1,21 MMs are often brain invasive and difficult to resect completely from the adjacent brain. Indeed, Sughrue et al actually suggested that for both primary surgery and repeat surgery, NTR may carry survival benefit over GTR.…”

Section: Surgerymentioning

confidence: 99%

“…Durand et al reported that radiotherapy was associated with increased OS in MMs, and Zhao et al reported that radiotherapy was associated with increased PFS and OS in MMs. 21,87 With WHO 2000/2007 Grade III tumors constituting only 1.6% of meningiomas and the preponderance of expert opinion in favor of radiotherapy for MMs, 83 the true efficacy of radiotherapy on WHO Grade III meningiomas is not likely to be evaluated in a randomized fashion even with multiinstitutional efforts. However, several reports have shown a benefit with dose-escalation of radiotherapy.…”

Section: Radiotherapymentioning

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

112

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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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Section: Radiotherapymentioning

confidence: 87%

Section: Treatment Algorithm For Amsmentioning

confidence: 99%

Section: Surgerymentioning

confidence: 99%

Section: Radiotherapymentioning

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

112

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“…The rate of progressionfree survival of patients with Grade 2 me ningiomas is approximately 50% at 5 years. 6,26 Multiple surgical procedures are usually required to control tumor recurrences. Repeated surgeries are associated with in creased morbidity, which can seriously affect a patient's quality of life.…”

Section: Natural History Of Grade 2 Meningiomamentioning

confidence: 99%

Grade 2 meningioma and radiosurgery

Aboukaïs¹,

Zaïri²,

Lejeune³

et al. 2015

JNS

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OBJECT World Health Organization Grade 2 meningiomas are aggressive tumors associated with a high recurrence rate leading to repeated surgical procedures, which can seriously worsen a patient's neurological status. Although radiosurgery is an increasingly popular technique, its role in the management of Grade 2 meningiomas has yet to be defined. In this study the authors aimed to evaluate radiosurgery in achieving control of proven tumor progression occurring after resection of Grade 2 meningioma. METHODS This retrospective study included consecutive patients who, between 2000 and 2012, had undergone radiosurgery for radiologically proven progression of a previously surgically treated Grade 2 meningioma. RESULTS Twenty-seven patients were eligible for analysis. There were 9 men and 18 women with a mean age of 59 years. The mean radiation dose was 15.2 Gy (range 12–21 Gy), and the mean target volume was 5.4 cm3 (range 0.194–14.2 cm3). Thirty-four radiosurgical procedures were performed in the 27 patients. The mean progression-free survival after radiosurgery was 32.4 months among those with progression in a target irradiated volume and 26.4 months among those with progression in any intracranial meninges. With a mean follow-up of 56.4 months (range 12–108 months), the 12-, 24-, and 36-month actuarial local control rates for all patients were 75%, 52%, and 40%, respectively, and the regional control rates were 75%, 48%, and 33%. A single case of transient hemiparesis completely resolved without sequelae. CONCLUSIONS Radiosurgery appears to be a safe and effective treatment for the local control of delayed progression after resection of a Grade 2 meningioma. Higher radiation doses similar to those applied for malignant tumors should be recommended when possible.

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Molecular Genetics of Meningioma

Smith

2016

Encyclopedia of Life Sciences

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Meningiomas are the most common primary brain tumours in the adult central nervous system. These tumours are not normally malignant, but can cause brain invasion and lead to various motor and sensory deficits, which are dependent on tumour location. Meningiomas are normally single, sporadic tumours, but can occur as multiple meningiomas. Neurofibromatosis type 2 ( NF2 ) mutations are the most common genetic cause of meningiomas and multiple meningiomas usually occur within the context of NF2 disease. Recent studies have identified a variety of other, less common, germline and somatic mutations in meningioma disease, showing that alternative mechanisms exist for the initiation and progression of meningioma growth. These discoveries will be useful for determining individual risk and prognosis and to develop individualised therapeutic strategies based on specific meningioma subtypes. Key Concepts Meningiomas are the most common tumours in the adult central nervous system. Most meningiomas are solitary tumours. The neurofibromatosis type 2 gene is the most common cause of meningiomas. Rare non‐NF2 meningioma predisposition genes can cause hereditary meningioma disease. A range of somatic alterations in meningiomas may cause tumour development via differing cellular pathways.

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WHO grade II and III meningiomas: a study of prognostic factors

Cited by 288 publications

References 27 publications

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

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

Grade 2 meningioma and radiosurgery

Molecular Genetics of Meningioma

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