Abstract
The purpose of this study is to summarize our experience in managing patients with an atypical or malignant meningioma at our institution, with a specific focus on determining the prognostic factors for treatment outcome. We reviewed the records of 126 patients with atypical or malignant meningiomas from January 2001 to August 2011. Data collected included gender, age, Karnofsky Performance Scale (KPS) score, pathology results, cleavability, and bone invasion. The symptoms and signs were recorded for further outcome analysis. There were 37 malignant meningiomas and 89 atypical meningiomas. Total resection (Simpson grade I–II) was achieved in 80.9 % of atypical patients (n = 72) and 67.6 % of malignant patients (n = 25). Forty patients (44.9 %) in the atypical group underwent radiotherapy after surgery, while 26 (70.2 %) patients underwent radiotherapy in the malignant group. The median follow-up duration was 25 months. Patients with a secondary tumor had a much shorter progression-free survival (PFS) than those with a primary tumor in the malignant group. The malignant meningioma group had lower overall survival. Progression-free survival for patients in the malignant group who received postoperative radiotherapy was longer than that for those who did not receive radiotherapy. In conclusion, total resection of the tumor was important because patients with a secondary tumor were much more likely to have recurrence than patients with a primary tumor in the atypical and malignant meningioma groups. Also, radiotherapy should be performed after surgery for a malignant meningioma.
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Hoi Sang, San Diego, USA
In this manuscript, the authors describe their experience with 89 atypical and 37 malignant meningioma treatments with surgical excision (total excision in 97 patients) with some followed by postoperative irradiation (66 patients). These patients were followed clinically for 2 to 8 years. The conclusions of the study are the following: (1) patients with secondary tumors have a much shorter progression-free survival (PFS) than those with primary tumors in the malignant group, (2) the malignant meningioma patients had a reduced overall survival, and (3) PFS in patients with malignant meningiomas who received postoperative radiotherapy is longer than those who did not receive radiotherapy.
This study is based on the experience of one of the most busy neurosurgical departments in China and is therefore worthy of note. With the detailed analysis of this extensive experience, this manuscript adds further to our knowledge of the natural history of atypical and malignant meningiomas especially in their need for and response to radiotherapy.
Peng Zhao and Mengqing Hu contribute equally to this study.
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Zhao, P., Hu, M., Zhao, M. et al. Prognostic factors for patients with atypical or malignant meningiomas treated at a single center. Neurosurg Rev 38, 101–107 (2015). https://doi.org/10.1007/s10143-014-0558-2
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DOI: https://doi.org/10.1007/s10143-014-0558-2