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01-12-2019 | Meningioma | Clinical Study

Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome

Authors: Annamaria Biczok, Christine Jungk, Rupert Egensperger, Andreas von Deimling, Bogdana Suchorska, Joerg C. Tonn, Christel Herold-Mende, Christian Schichor

Published in: Journal of Neuro-Oncology | Issue 3/2019

Abstract

Purpose

For meningiomas, the 2016 revision of the WHO classification introduced brain invasion per se as a sufficient condition to classify as grade II. We analyzed whether meningiomas previously graded as WHO grade I differ in prognosis depending on the presence of microscopic brain invasion.

Methods

A consecutive series of patients with intracranial meningioma WHO grade I (± brain invasion) at two neurosurgical departments was analyzed retrospectively. Cox regression models on progression-free survival (PFS) and Kaplan–Meier survival estimates were performed.

Results

875 adult patients were included. Histological diagnosis of brain invasion was confirmed in 28 patients. Median follow-up was 73 months. In univariate and multivariate models, gross total resection gained favorable prognostic influence for PFS (p < 0.001, HR: 0.237, CI 0.170–0.382). 170 patients with the brain/meningioma interface present in histopathological specimen were separately analyzed as a subgroup. Importantly, presence of brain invasion did not reach significance for PFS, even in the subgroup with available specimen of brain/meningioma interface (p = 0.787, HR: 0.852, CI 0.268–2.710 and p = 0.811, HR: 0.848, CI 0.222–3.246, respectively). Patients with and without brain invasion did not differ in terms of age, tumor location and extent of resection, but were more likely to receive radiotherapy (p = 0.03) of tumor remnants. However, subgroup analysis of non-irradiated tumors revealed no prognostic influence of brain invasion (p = 0.749, HR: 0.772, CI 0.158–3.767).

Conclusions

In this bi-institutional series, brain invasion was frequent among meningiomas WHO grade I when brain/meningioma interface was available for histology (16.5%). However, brain invasion did not impact early recurrence.

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Title: Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome
Authors: Annamaria Biczok
Christine Jungk
Rupert Egensperger
Andreas von Deimling
Bogdana Suchorska
Joerg C. Tonn
Christel Herold-Mende
Christian Schichor
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Meningioma
Meningioma
Radiotherapy
Published in: Journal of Neuro-Oncology / Issue 3/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03312-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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