Surgical management of de novo metastatic meningioma of the spine: An underestimated issue for WHO grade II/III meningiomas
Meningioma is a slow-growing neoplasm derived from meningothelial cells. Extradural metastasis of WHO grade II/III meningiomas is relatively rare, and spinal metastatic meningiomas (SMM) have only been described in individual case reports. The aim of the present study is to discuss the clinical feat...
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| Veröffentlicht in: | Clinical neurology and neurosurgery 2021-11, Vol.210, p.106995-106995, Article 106995 |
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| creator | Jia, Qi Wu, Zhipeng Chu, Ruitong Zhao, Chenglong Wang, Ting Zhou, Zhenhua Cai, Xiaopan Yang, Xinghai Xiao, Jianru |
| description | Meningioma is a slow-growing neoplasm derived from meningothelial cells. Extradural metastasis of WHO grade II/III meningiomas is relatively rare, and spinal metastatic meningiomas (SMM) have only been described in individual case reports. The aim of the present study is to discuss the clinical features and treatments of SMM patients.
Fourteen SMM patients who received surgery in our center between 2010 and 2020 were reviewed retrospectively. Possible prognostic factors affecting local progression-free survival (LPFS) and overall survival (OS) were analyzed by log-rank analysis.
Our series comprised nine men and five women, with a median age of 49 years. The interval from the primary treatment to SMM varied from 1 to 11 years. Lesions were mainly located in the lumbar-sacral region (7/14, 50.0%), followed by the thoracic spine (5/14, 35.7%) and cervical (2/14, 14.3%) spine. The median follow-up period was 42.7 months, during which six patients (42.9%) passed away. Local tumor progression was detected in four patients (28.6%). Log-rank analysis indicated that circumferential surgery was associated with good LPFS, whereas WHO grade III and visceral metastasis were factors adversely affecting OS.
SMM is a challenging clinical entity, usually occurring in the fourth to fifth decades of life. Circumferential surgery is associated with good LPFS. WHO grade III and visceral metastasis are factors adversely affecting OS of patients with SMM. Long-term follow-up is recommended for patients who have received surgical treatment for primary meningiomas (Simpson Grade III/IV), especially for WHO III lesions.
•Spinal metastatic meningioma (SMM) is a challenging clinical entity, usually occurring in the fourth to fifth decades.•Circumferential surgery is associated with good LPFS, and radiotherapy is a useful supplementary treatment after debulking surgery.•WHO grade III and visceral metastasis are adverse factors for overall survival (OS) of SMM patients. |
| doi_str_mv | 10.1016/j.clineuro.2021.106995 |
| format | Article |
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Fourteen SMM patients who received surgery in our center between 2010 and 2020 were reviewed retrospectively. Possible prognostic factors affecting local progression-free survival (LPFS) and overall survival (OS) were analyzed by log-rank analysis.
Our series comprised nine men and five women, with a median age of 49 years. The interval from the primary treatment to SMM varied from 1 to 11 years. Lesions were mainly located in the lumbar-sacral region (7/14, 50.0%), followed by the thoracic spine (5/14, 35.7%) and cervical (2/14, 14.3%) spine. The median follow-up period was 42.7 months, during which six patients (42.9%) passed away. Local tumor progression was detected in four patients (28.6%). Log-rank analysis indicated that circumferential surgery was associated with good LPFS, whereas WHO grade III and visceral metastasis were factors adversely affecting OS.
SMM is a challenging clinical entity, usually occurring in the fourth to fifth decades of life. Circumferential surgery is associated with good LPFS. WHO grade III and visceral metastasis are factors adversely affecting OS of patients with SMM. Long-term follow-up is recommended for patients who have received surgical treatment for primary meningiomas (Simpson Grade III/IV), especially for WHO III lesions.
•Spinal metastatic meningioma (SMM) is a challenging clinical entity, usually occurring in the fourth to fifth decades.•Circumferential surgery is associated with good LPFS, and radiotherapy is a useful supplementary treatment after debulking surgery.•WHO grade III and visceral metastasis are adverse factors for overall survival (OS) of SMM patients.</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2021.106995</identifier><identifier>PMID: 34715555</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Brain cancer ; Case reports ; Child ; Circumferential resection ; Disease Management ; Female ; Follow-Up Studies ; Humans ; Male ; Medical imaging ; Medical prognosis ; Meningeal Neoplasms - diagnostic imaging ; Meningeal Neoplasms - surgery ; Meningioma ; Meningioma - diagnostic imaging ; Meningioma - surgery ; Metastases ; Metastasis ; Middle Aged ; Neoplasm Grading ; Neurology ; Patients ; Radiotherapy ; Sacrum ; Spinal Neoplasms - diagnostic imaging ; Spinal Neoplasms - surgery ; Spine (lumbar) ; Spine (thoracic) ; Spine metastasis ; Surgery ; Survival analysis ; Tumors ; WHO grade ; Young Adult</subject><ispartof>Clinical neurology and neurosurgery, 2021-11, Vol.210, p.106995-106995, Article 106995</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><rights>2021. Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-3a9057a0a966c9fc347ff6204f4121917f401e8c43c7076727cf6d50de5d5acf3</citedby><cites>FETCH-LOGICAL-c396t-3a9057a0a966c9fc347ff6204f4121917f401e8c43c7076727cf6d50de5d5acf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2599066136?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982,64370,64372,64374,72224</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34715555$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jia, Qi</creatorcontrib><creatorcontrib>Wu, Zhipeng</creatorcontrib><creatorcontrib>Chu, Ruitong</creatorcontrib><creatorcontrib>Zhao, Chenglong</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Zhou, Zhenhua</creatorcontrib><creatorcontrib>Cai, Xiaopan</creatorcontrib><creatorcontrib>Yang, Xinghai</creatorcontrib><creatorcontrib>Xiao, Jianru</creatorcontrib><title>Surgical management of de novo metastatic meningioma of the spine: An underestimated issue for WHO grade II/III meningiomas</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>Meningioma is a slow-growing neoplasm derived from meningothelial cells. Extradural metastasis of WHO grade II/III meningiomas is relatively rare, and spinal metastatic meningiomas (SMM) have only been described in individual case reports. The aim of the present study is to discuss the clinical features and treatments of SMM patients.
Fourteen SMM patients who received surgery in our center between 2010 and 2020 were reviewed retrospectively. Possible prognostic factors affecting local progression-free survival (LPFS) and overall survival (OS) were analyzed by log-rank analysis.
Our series comprised nine men and five women, with a median age of 49 years. The interval from the primary treatment to SMM varied from 1 to 11 years. Lesions were mainly located in the lumbar-sacral region (7/14, 50.0%), followed by the thoracic spine (5/14, 35.7%) and cervical (2/14, 14.3%) spine. The median follow-up period was 42.7 months, during which six patients (42.9%) passed away. Local tumor progression was detected in four patients (28.6%). Log-rank analysis indicated that circumferential surgery was associated with good LPFS, whereas WHO grade III and visceral metastasis were factors adversely affecting OS.
SMM is a challenging clinical entity, usually occurring in the fourth to fifth decades of life. Circumferential surgery is associated with good LPFS. WHO grade III and visceral metastasis are factors adversely affecting OS of patients with SMM. Long-term follow-up is recommended for patients who have received surgical treatment for primary meningiomas (Simpson Grade III/IV), especially for WHO III lesions.
•Spinal metastatic meningioma (SMM) is a challenging clinical entity, usually occurring in the fourth to fifth decades.•Circumferential surgery is associated with good LPFS, and radiotherapy is a useful supplementary treatment after debulking surgery.•WHO grade III and visceral metastasis are adverse factors for overall survival (OS) of SMM patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Brain cancer</subject><subject>Case reports</subject><subject>Child</subject><subject>Circumferential resection</subject><subject>Disease Management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Meningeal Neoplasms - diagnostic imaging</subject><subject>Meningeal Neoplasms - surgery</subject><subject>Meningioma</subject><subject>Meningioma - diagnostic imaging</subject><subject>Meningioma - surgery</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neurology</subject><subject>Patients</subject><subject>Radiotherapy</subject><subject>Sacrum</subject><subject>Spinal Neoplasms - diagnostic imaging</subject><subject>Spinal Neoplasms - surgery</subject><subject>Spine (lumbar)</subject><subject>Spine (thoracic)</subject><subject>Spine metastasis</subject><subject>Surgery</subject><subject>Survival analysis</subject><subject>Tumors</subject><subject>WHO grade</subject><subject>Young Adult</subject><issn>0303-8467</issn><issn>1872-6968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcFrHCEUxiW0NNu0_0IQcullNjrO6JhTQ2ibgUAObchRrD43LjO6VScQ8s_XZZNSeum7-JDf-_x8H0KnlKwpofx8uzaTD7CkuG5JS-sll7I_Qis6iLbhkg9v0Iowwpqh4-IYvc95SwhhjA_v0DHrBO1rrdDz9yVtvNETnnXQG5ghFBwdtoBDfIx4hqJz0cWb2gYfNj7Oeg-UB8B5Vy1c4MuAl2AhQS5-1gUs9jkvgF1M-P76Fm-SrnLjeD6O418q-QN66_SU4ePLeYLuvn75cXXd3Nx-G68ubxrDJC8N05L0QhMtOTfSmWreOd6SznW0pZIK1xEKg-mYEURw0QrjuO2Jhd722jh2gj4ddHcp_lqqSzX7bGCadIC4ZNX2klDW1_1V9OwfdBuXFKq7PSUJ55TxSvEDZVLMOYFTu1R_np4UJWofj9qq13jUPh51iKcOnr7ILz9nsH_GXvOowOcDAHUfjx6SysZDMGB9AlOUjf5_b_wGFiOkFw</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Jia, Qi</creator><creator>Wu, Zhipeng</creator><creator>Chu, Ruitong</creator><creator>Zhao, Chenglong</creator><creator>Wang, Ting</creator><creator>Zhou, Zhenhua</creator><creator>Cai, Xiaopan</creator><creator>Yang, Xinghai</creator><creator>Xiao, Jianru</creator><general>Elsevier B.V</general><general>Elsevier Limited</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>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Surgical management of de novo metastatic meningioma of the spine: An underestimated issue for WHO grade II/III meningiomas</title><author>Jia, Qi ; 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Extradural metastasis of WHO grade II/III meningiomas is relatively rare, and spinal metastatic meningiomas (SMM) have only been described in individual case reports. The aim of the present study is to discuss the clinical features and treatments of SMM patients.
Fourteen SMM patients who received surgery in our center between 2010 and 2020 were reviewed retrospectively. Possible prognostic factors affecting local progression-free survival (LPFS) and overall survival (OS) were analyzed by log-rank analysis.
Our series comprised nine men and five women, with a median age of 49 years. The interval from the primary treatment to SMM varied from 1 to 11 years. Lesions were mainly located in the lumbar-sacral region (7/14, 50.0%), followed by the thoracic spine (5/14, 35.7%) and cervical (2/14, 14.3%) spine. The median follow-up period was 42.7 months, during which six patients (42.9%) passed away. Local tumor progression was detected in four patients (28.6%). Log-rank analysis indicated that circumferential surgery was associated with good LPFS, whereas WHO grade III and visceral metastasis were factors adversely affecting OS.
SMM is a challenging clinical entity, usually occurring in the fourth to fifth decades of life. Circumferential surgery is associated with good LPFS. WHO grade III and visceral metastasis are factors adversely affecting OS of patients with SMM. Long-term follow-up is recommended for patients who have received surgical treatment for primary meningiomas (Simpson Grade III/IV), especially for WHO III lesions.
•Spinal metastatic meningioma (SMM) is a challenging clinical entity, usually occurring in the fourth to fifth decades.•Circumferential surgery is associated with good LPFS, and radiotherapy is a useful supplementary treatment after debulking surgery.•WHO grade III and visceral metastasis are adverse factors for overall survival (OS) of SMM patients.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>34715555</pmid><doi>10.1016/j.clineuro.2021.106995</doi><tpages>1</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Brain cancer Case reports Child Circumferential resection Disease Management Female Follow-Up Studies Humans Male Medical imaging Medical prognosis Meningeal Neoplasms - diagnostic imaging Meningeal Neoplasms - surgery Meningioma Meningioma - diagnostic imaging Meningioma - surgery Metastases Metastasis Middle Aged Neoplasm Grading Neurology Patients Radiotherapy Sacrum Spinal Neoplasms - diagnostic imaging Spinal Neoplasms - surgery Spine (lumbar) Spine (thoracic) Spine metastasis Surgery Survival analysis Tumors WHO grade Young Adult |
| title | Surgical management of de novo metastatic meningioma of the spine: An underestimated issue for WHO grade II/III meningiomas |
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