Necrosis is a consistent factor to recurrence of meningiomas: should it be a stand-alone grading criterion for grade II meningioma?
The purpose of this study was to evaluate spontaneous necrosis as a possible isolated factor for progression and recurrence in grade I meningiomas classified according to the current World Health Organization (WHO) classification. Meningiomas are the most frequently reported primary intracranial tum...
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| Veröffentlicht in: | Journal of neuro-oncology 2018-04, Vol.137 (2), p.331-336 |
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| creator | Góes, Pedro Santos, Bruno Fernandes Oliveira Suzuki, Fernando Seiji Salles, Débora Stávale, João Noberto Cavalheiro, Sérgio de Paiva Neto, Manoel Antônio |
| description | The purpose of this study was to evaluate spontaneous necrosis as a possible isolated factor for progression and recurrence in grade I meningiomas classified according to the current World Health Organization (WHO) classification. Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%. The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign), II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence. Among 110 patients with intracranial meningiomas, 70 were WHO grade I meningiomas with no findings of atypia (G1WON), 15 were WHO grade I with necrosis (G1WN), 21 were WHO grade II (G2), and 4 were WHO grade III (G3). The mean follow-up was 5.9 ± 0.2 years. High performance scale (KPS ≥ 80) was different (p |
| doi_str_mv | 10.1007/s11060-017-2721-4 |
| format | Article |
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Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%. The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign), II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence. Among 110 patients with intracranial meningiomas, 70 were WHO grade I meningiomas with no findings of atypia (G1WON), 15 were WHO grade I with necrosis (G1WN), 21 were WHO grade II (G2), and 4 were WHO grade III (G3). The mean follow-up was 5.9 ± 0.2 years. High performance scale (KPS ≥ 80) was different (p < 0.001) between WHO grade I meningiomas without (81.4%) and with (60%) necrosis. The 5-year mortality rate was 1.4, 6.7 and 5.9% for G1WON, G1WN and G2, respectively, with significant difference (p = 0.011) related to the presence of necrosis. The risk of recurrence was 3.7 times higher in G1WN than in G1WON (p = 0.017), and 4.2 times in G2 (p = 0.010). Progression-free survival (PFS) was clearly higher in patients with G1WON compared to G1WN and G2 (p = 0.002 and p < 0.001, respectively). There was no significant difference in PFS between G1WN and G2 (p = 0.692). Retreatment was also superior in meningioma with necrosis. Our findings provide clear statistical data to consider that patients with benign meningiomas and histologic findings of spontaneous necrosis are at increased risk of progression and recurrence compared to those with benign lesion without atypical features. Statistical analysis curves also suggest that these lesions behave more similarly to those currently classified as WHO grade II meningioma.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-017-2721-4</identifier><identifier>PMID: 29270884</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Benign ; Brain cancer ; Central nervous system ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Gangrene ; Humans ; Male ; Medicine ; Medicine & Public Health ; Meningeal Neoplasms - diagnosis ; Meningeal Neoplasms - mortality ; Meningeal Neoplasms - pathology ; Meningeal Neoplasms - therapy ; Meningioma ; Meningioma - diagnosis ; Meningioma - mortality ; Meningioma - pathology ; Meningioma - therapy ; Middle Aged ; Necrosis ; Necrosis - diagnosis ; Neoplasm Grading ; Neurology ; Oncology ; Prognosis ; Recurrence ; Retreatment ; Retrospective Studies ; Statistical analysis ; Statistics ; Tumors ; Young Adult</subject><ispartof>Journal of neuro-oncology, 2018-04, Vol.137 (2), p.331-336</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2017</rights><rights>Journal of Neuro-Oncology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f5a352c654be314d33a026694a22072d433e9fe084cc89238e25950ec8ae9b7e3</citedby><cites>FETCH-LOGICAL-c372t-f5a352c654be314d33a026694a22072d433e9fe084cc89238e25950ec8ae9b7e3</cites><orcidid>0000-0001-5826-9158</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-017-2721-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-017-2721-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29270884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Góes, Pedro</creatorcontrib><creatorcontrib>Santos, Bruno Fernandes Oliveira</creatorcontrib><creatorcontrib>Suzuki, Fernando Seiji</creatorcontrib><creatorcontrib>Salles, Débora</creatorcontrib><creatorcontrib>Stávale, João Noberto</creatorcontrib><creatorcontrib>Cavalheiro, Sérgio</creatorcontrib><creatorcontrib>de Paiva Neto, Manoel Antônio</creatorcontrib><title>Necrosis is a consistent factor to recurrence of meningiomas: should it be a stand-alone grading criterion for grade II meningioma?</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>The purpose of this study was to evaluate spontaneous necrosis as a possible isolated factor for progression and recurrence in grade I meningiomas classified according to the current World Health Organization (WHO) classification. Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%. The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign), II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence. Among 110 patients with intracranial meningiomas, 70 were WHO grade I meningiomas with no findings of atypia (G1WON), 15 were WHO grade I with necrosis (G1WN), 21 were WHO grade II (G2), and 4 were WHO grade III (G3). The mean follow-up was 5.9 ± 0.2 years. High performance scale (KPS ≥ 80) was different (p < 0.001) between WHO grade I meningiomas without (81.4%) and with (60%) necrosis. The 5-year mortality rate was 1.4, 6.7 and 5.9% for G1WON, G1WN and G2, respectively, with significant difference (p = 0.011) related to the presence of necrosis. The risk of recurrence was 3.7 times higher in G1WN than in G1WON (p = 0.017), and 4.2 times in G2 (p = 0.010). Progression-free survival (PFS) was clearly higher in patients with G1WON compared to G1WN and G2 (p = 0.002 and p < 0.001, respectively). There was no significant difference in PFS between G1WN and G2 (p = 0.692). Retreatment was also superior in meningioma with necrosis. Our findings provide clear statistical data to consider that patients with benign meningiomas and histologic findings of spontaneous necrosis are at increased risk of progression and recurrence compared to those with benign lesion without atypical features. Statistical analysis curves also suggest that these lesions behave more similarly to those currently classified as WHO grade II meningioma.</description><subject>Adult</subject><subject>Aged</subject><subject>Benign</subject><subject>Brain cancer</subject><subject>Central nervous system</subject><subject>Classification</subject><subject>Clinical Study</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gangrene</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meningeal Neoplasms - diagnosis</subject><subject>Meningeal Neoplasms - mortality</subject><subject>Meningeal Neoplasms - pathology</subject><subject>Meningeal Neoplasms - therapy</subject><subject>Meningioma</subject><subject>Meningioma - diagnosis</subject><subject>Meningioma - mortality</subject><subject>Meningioma - pathology</subject><subject>Meningioma - therapy</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Necrosis - diagnosis</subject><subject>Neoplasm Grading</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Retreatment</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Statistics</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFTEUhoMo9lr9AW5KwE030ZOPmUzcSCm1vVB0o-Au5GbOXKfMJG2SWbjuHzfTW6UIQiAhec6Tw3kJecvhPQfQHzLn0AIDrpnQgjP1jGx4oyXTUsvnZAO81awx6scReZXzDQAoLflLciSM0NB1akPuv6BPMY-Z1uWoj6GeC4ZCB-dLTLREmtAvKWHwSONAZwxj2I9xdvkjzT_jMvV0LHSHtTwXF3rmphiQ7pPrK0h9GgumMQY6VN16i3S7faL59Jq8GNyU8c3jfky-f774dn7Frr9ebs_PrpmXWhQ2NE42wreN2qHkqpfSgWhbo5wQoEWvpEQzIHTK-84I2aFoTAPoO4dmp1Eek9OD9zbFuwVzsfOYPU6TCxiXbLnRxrQdGFXRd_-gN3FJoXb3QLWtaASvFD9Q6whzwsHepnF26ZflYNeE7CEhWxOya0J2NZ88mpfdjP3fij-RVEAcgFyfwh7Tk6__a_0NMvebog</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Góes, Pedro</creator><creator>Santos, Bruno Fernandes Oliveira</creator><creator>Suzuki, Fernando Seiji</creator><creator>Salles, Débora</creator><creator>Stávale, João Noberto</creator><creator>Cavalheiro, Sérgio</creator><creator>de Paiva Neto, Manoel Antônio</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5826-9158</orcidid></search><sort><creationdate>20180401</creationdate><title>Necrosis is a consistent factor to recurrence of meningiomas: should it be a stand-alone grading criterion for grade II meningioma?</title><author>Góes, Pedro ; 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Meningiomas are the most frequently reported primary intracranial tumours, accounting for more than 35%. The 2016 WHO classification of central nervous system tumors stratifies meningiomas in grades I (benign), II (atypical), and III (malignant), according to histopathological aspects and the risk of progression or recurrence. Among 110 patients with intracranial meningiomas, 70 were WHO grade I meningiomas with no findings of atypia (G1WON), 15 were WHO grade I with necrosis (G1WN), 21 were WHO grade II (G2), and 4 were WHO grade III (G3). The mean follow-up was 5.9 ± 0.2 years. High performance scale (KPS ≥ 80) was different (p < 0.001) between WHO grade I meningiomas without (81.4%) and with (60%) necrosis. The 5-year mortality rate was 1.4, 6.7 and 5.9% for G1WON, G1WN and G2, respectively, with significant difference (p = 0.011) related to the presence of necrosis. The risk of recurrence was 3.7 times higher in G1WN than in G1WON (p = 0.017), and 4.2 times in G2 (p = 0.010). Progression-free survival (PFS) was clearly higher in patients with G1WON compared to G1WN and G2 (p = 0.002 and p < 0.001, respectively). There was no significant difference in PFS between G1WN and G2 (p = 0.692). Retreatment was also superior in meningioma with necrosis. Our findings provide clear statistical data to consider that patients with benign meningiomas and histologic findings of spontaneous necrosis are at increased risk of progression and recurrence compared to those with benign lesion without atypical features. Statistical analysis curves also suggest that these lesions behave more similarly to those currently classified as WHO grade II meningioma.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29270884</pmid><doi>10.1007/s11060-017-2721-4</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5826-9158</orcidid></addata></record> |
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| subjects | Adult Aged Benign Brain cancer Central nervous system Classification Clinical Study Female Follow-Up Studies Gangrene Humans Male Medicine Medicine & Public Health Meningeal Neoplasms - diagnosis Meningeal Neoplasms - mortality Meningeal Neoplasms - pathology Meningeal Neoplasms - therapy Meningioma Meningioma - diagnosis Meningioma - mortality Meningioma - pathology Meningioma - therapy Middle Aged Necrosis Necrosis - diagnosis Neoplasm Grading Neurology Oncology Prognosis Recurrence Retreatment Retrospective Studies Statistical analysis Statistics Tumors Young Adult |
| title | Necrosis is a consistent factor to recurrence of meningiomas: should it be a stand-alone grading criterion for grade II meningioma? |
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