Prognostic factors and the management of anaplastic meningioma

Gui-Jun Zhang; Yun-Sheng Zhang; Guo-Bin Zhang; Da Li; Li-Wei Zhang; Zhen Wu; Jun-Ting Zhang

doi:10.1016/j.clineuro.2018.03.028

Prognostic factors and the management of anaplastic meningioma

Clin Neurol Neurosurg. 2018 Jul:170:13-19. doi: 10.1016/j.clineuro.2018.03.028. Epub 2018 Mar 27.

Authors

Gui-Jun Zhang¹, Yun-Sheng Zhang², Guo-Bin Zhang¹, Da Li¹, Li-Wei Zhang¹, Zhen Wu¹, Jun-Ting Zhang³

Affiliations

¹ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng District, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng District, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China; Brain Tumor Research Center, Beijing Neurosurgical Institute, Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Tiantan Xili 6, Dongcheng District, Beijing 100050, China.
³ Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng District, Beijing, 100050, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Brain Tumor, Beijing, China. Electronic address: zhangjunting2003@aliyun.com.

PMID: 29715576
DOI: 10.1016/j.clineuro.2018.03.028

Abstract

Objectives: Anaplastic meningiomas (AMs)tend to have a higher local recurrence rate and metastasize. but few studies have reported on the prognosis and management of patients with AM, this study aimed to increase the understanding of the prognosis, management and history of AM.

Patients and methods: All patients (n = 56) underwent surgeries in our hospital between December 2008 and January 2016. Postoperative pathology reports confirmed the diagnosis of AM. Prognostic factors and the management were analysed in this study. AM was then divided into two groups. One group was primary AM, the other group was secondary AM.

Results: Of all the 56 AM patients, 31 were male and 25 were female (male to female ratio of 1.24:1). The 1-, 3-, and 5-year progression-free survival (PFS) rates were 78.6%, 41.1% and 29.7%, respectively, and the corresponding overall survival (OS) rates were 82.1%, 50.1% and 45.0%, respectively. Homogeneous contrast might be a potential better prognostic factor for PFS (HR = 1.824, P = 0.083). Treatment with postoperative radiotherapy (PRT) was significantly associated with longer PFS (HR = 0.390, P = 0.007) and OS (HR = 0.376, P = 0.008) according to univariate analysis. Gross-total resection (GTR) was a favourable factor for PFS (HR = 2.059, P = 0.035) and OS (HR = 2.802, P = 0.004).

Conclusion: Achieving GTR is a favourable treatment strategy for patients with AM in our study and patients receiving PRT after resection is essential.

Keywords: Anaplastic meningioma; Prognosis; Treatment; Tumor progression.

MeSH terms

Adolescent
Adult
Aged
Child
Cohort Studies
Disease Management
Disease-Free Survival
Female
Humans
Male
Meningeal Neoplasms / diagnostic imaging*
Meningeal Neoplasms / mortality*
Meningeal Neoplasms / therapy
Meningioma / diagnostic imaging*
Meningioma / mortality*
Meningioma / therapy
Middle Aged
Neoplasm Recurrence, Local / diagnostic imaging*
Neoplasm Recurrence, Local / mortality*
Neoplasm Recurrence, Local / therapy
Prognosis
Retrospective Studies
Salvage Therapy / methods
Salvage Therapy / mortality
Survival Rate / trends
Young Adult