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01-04-2021 | Meningioma | Review Article

Prognostic significance of brain invasion in meningiomas: systematic review and meta-analysis

Authors: Satoshi Nakasu, Yoko Nakasu

Published in: Brain Tumor Pathology | Issue 2/2021

Abstract

The WHO 2016 classification introduced brain invasion as a standalone criterion for grade II meningioma (GIIM). We systematically reviewed studies published after 2000 and performed a PRISMA-compliant meta-analysis of the hazard ratios (HRs) for progression-free survival (PFS) between brain-invasive and noninvasive meningiomas. In five studies that included both benign and higher-grade meningiomas, brain invasion was a significant risk factor for recurrence (HR = 2.45, p = 0.0004). However, in 3 studies comparing “brain-invasive meningioma with otherwise benign histology (BIOB)” with grade I meningioma, brain invasion was not a significant predictor of PFS (HR = 1.49, p = 0.23). Among GIIM per the WHO 2000 criteria, brain invasion was a significant predictor of shorter PFS than noninvasive GIIM (HR = 3.40, p = 0.001) but not per the WHO 2016 criteria (HR 1.13, p = 0.54), as the latter includes BIOB. Meta-regression analysis of seven studies of grade II meningioma showed that more frequent BIOB was associated with lower HRs (p < 0.0001). Hence, there is no rationale for brain invasion as a standalone criterion for grade II meningioma, although almost all studies were retrospective and exhibited highly heterogeneous HRs due to differences in brain–tumor interface data availability.

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Title: Prognostic significance of brain invasion in meningiomas: systematic review and meta-analysis
Authors: Satoshi Nakasu
Yoko Nakasu
Publication date: 01-04-2021
Publisher: Springer Singapore
Keywords: Meningioma
Meningioma
Published in: Brain Tumor Pathology / Issue 2/2021
Print ISSN: 1433-7398
Electronic ISSN: 1861-387X
DOI: https://doi.org/10.1007/s10014-020-00390-y

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Prognostic significance of brain invasion in meningiomas: systematic review and meta-analysis

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