Imaging and extent of surgical resection predict risk of meningioma recurrence better than WHO histopathological grade.

摘要: Risk stratification of meningiomas by histopathological grade alone is insufficient because it does not reliably predict which patients will progress/recur after definitive treatment. We sought to determine whether preoperative imaging and clinical characteristics could and/or improve prognostication progression/recurrence (P/R). retrospectively reviewed 144 divided into low-grade (2007 WHO I; n = 118) high-grade grades II/III; 26) groups that underwent surgery between 2002-2013 (median follow-up 49 months) had MR with diffusion-weighted head CT. Multivariate logistic regression analysis yielded an optimized model based on associations histopathology male gender, low apparent diffusion coefficient (ADC), absent calcification, high peritumoral edema. Of these parameters, the logarithm ADC strongest association (OR 0.001 [0.0002-0.07]; P 0.001). Interestingly, only demonstrated a borderline significant P/R (HR 2.01 [0.9-4.3]; 0.08). Remarkably, multivariate Cox proportional-hazards extent resection outperformed current standard, grade, in predicting suffer initial Stratification four risk Simpson (I vs. other) dichotomized (high low) significantly correlated (P 0.003). The high-risk group (non-Simpson I, ADC; 31) 45% cumulative incidence whereas low-risk (Simpson no events at five years Independent treated adjuvant radiotherapy lower five-year crude rate compared those who did receive (17% 59%). Hence, non-Simpson I are increased may benefit from more aggressive treatment involving additional surgery.