13 results on '"Meling, Torstein R."'
Search Results
2. WHO grade I meningiomas: classification-tree for prognostic factors of survival
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Lemée, Jean-Michel, Joswig, Holger, Da Broi, Michele, Corniola, Marco Vincenzo, Scheie, David, Schaller, Karl, Helseth, Eirik, and Meling, Torstein R.
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- 2020
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3. Skull base versus non-skull base meningioma surgery in the elderly
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Meling, Torstein R., Da Broi, Michele, Scheie, David, and Helseth, Eirik
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- 2019
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4. Posterior fossa meningiomas: perioperative predictors of extent of resection, overall survival and progression-free survival
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Corniola, Marco V., Lemée, Jean-Michel, Da Broi, Michele, Joswig, Holger, Schaller, Karl, Helseth, Eirik, and Meling, Torstein R.
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- 2019
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5. Meningiomas: skull base versus non-skull base
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Meling, Torstein R., Da Broi, Michele, Scheie, David, and Helseth, Eirik
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- 2019
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6. The role of surgery in intracranial PCNSL
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Jahr, Guro, Da Broi, Michele, Holte, Jr, Harald, Beiske, Klaus, and Meling, Torstein R.
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- 2018
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7. Anaplastic astrocytomas: survival and prognostic factors in a surgical series
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Rogne, Siril G., Konglund, Ane, Scheie, David, Helseth, Eirik, and Meling, Torstein R.
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- 2014
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8. Management of Recurrent Meningiomas: State of the Art and Perspectives.
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Corniola, Marco Vincenzo and Meling, Torstein R.
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MEDICAL databases , *ONLINE information services , *MEDICAL information storage & retrieval systems , *SYSTEMATIC reviews , *CANCER relapse , *MEDICAL protocols , *MENINGIOMA , *DESCRIPTIVE statistics , *MEDLINE , *PROGRESSION-free survival , *WORLD Wide Web - Abstract
Simple Summary: Intracranial meningiomas account for 30% to 40% of the primary lesions of the central nervous system. Surgery is the mainstay treatment whenever symptoms related to an intra-cranial meningioma are encountered. However, the management of recurrences after initial surgery, which are not uncommon, is still a matter of debate. Here, we present the alternatives described in the management of meningioma recurrence (radiotherapy, stereotaxic radiosurgery, protontherapy, and chemotherapy, among others). Their overall results are compared to surgery and future perspectives are presented. Background: While meningiomas often recur over time, the natural history of repeated recurrences and their management are not well described. Should recurrence occur, repeat surgery and/or use of adjuvant therapeutic options may be necessary. Here, we summarize current practice when it comes to meningioma recurrence after initial surgical management. Methods: A total of N = 89 articles were screened. N = 41 articles met the inclusion criteria and N = 16 articles failed to assess management of meningioma recurrence. Finally, N = 24 articles were included in our review. Results: The articles were distributed as follows: studies on chemotherapy (N = 14), radiotherapy, protontherapy, and stereotaxic radiosurgery (N = 6), boron-neutron capture therapy (N = 2) and surgery (N = 3). No study seems to provide serious alternatives to surgery in terms of progression-free and overall survival. Recurrence can occur long after the initial surgery and also affects WHO grade 1 meningiomas, even after initial gross total resection at first surgery, emphasizing the need for a long-term and comprehensive follow-up. Conclusions: Surgery still seems to be the state-of-the-art management when it comes to meningioma recurrence, since none of the non-surgical alternatives show promising results in terms of progression-free and overall survival. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Robust association between vascular habitats and patient prognosis in glioblastoma: an international retrospective multicenter study
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Álvarez-Torres, María del Mar, Juan-Albarracín, Javier, Fuster García, Elíes, Bellvís-Bataller, Fuensanta, Lorente, David, Reynés, Gaspar, Font de Mora, Jaime, Aparici-Robles, Fernando, Botella, Carlos, Muñoz-Langa, Jose, Faubel, Raquel, Asensio-Cuesta, Sabina, García-Ferrando, Germán A., Chelebian, Eduard, Auger, Cristina, Pineda, Jose, Rovira, Alex, Oleaga, Laura, Mollà Olmos, Enrique, Revert, Antonio J., Tshibanda, Luaba, Crisi, Girolamo, Emblem, Kyrre E., Martin, Didier, Due-Tønnessen, Paulina, Meling, Torstein R., Filice, Silvano, Sáez Silvestre, Carlos, and Garcia-Gomez, Juan M
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Vascularity ,FISICA APLICADA ,Perfusion DSC ,Overall survival ,Glioblastoma ,PROYECTOS DE INGENIERIA ,Multicenter study - Abstract
[EN] Background Glioblastoma (GBM) is the most aggressive primary brain tumor, characterized by a heterogeneous and abnormal vascularity. Subtypes of vascular habitats within the tumor and edema can be distinguished: high angiogenic tumor (HAT), low angiogenic tumor (LAT), infiltrated peripheral edema (IPE), and vasogenic peripheral edema (VPE). Purpose To validate the association between hemodynamic markers from vascular habitats and overall survival (OS) in glioblastoma patients, considering the intercenter variability of acquisition protocols. Study Type Multicenter retrospective study. Population In all, 184 glioblastoma patients from seven European centers participating in the NCT03439332 clinical study. Field Strength/Sequence 1.5T (for 54 patients) or 3.0T (for 130 patients). Pregadolinium and postgadolinium-based contrast agent-enhanced T-1-weighted MRI, T-2- and FLAIR T-2-weighted, and dynamic susceptibility contrast (DSC) T-2* perfusion. Assessment We analyzed preoperative MRIs to establish the association between the maximum relative cerebral blood volume (rCBV(max)) at each habitat with OS. Moreover, the stratification capabilities of the markers to divide patients into "vascular" groups were tested. The variability in the markers between individual centers was also assessed. Statistical Tests Uniparametric Cox regression; Kaplan-Meier test; Mann-Whitney test. Results The rCBV(max) derived from the HAT, LAT, and IPE habitats were significantly associated with patient OS (P < 0.05; hazard ratio [HR]: 1.05, 1.11, 1.28, respectively). Moreover, these markers can stratify patients into "moderate-" and "high-vascular" groups (P < 0.05). The Mann-Whitney test did not find significant differences among most of the centers in markers (HAT: P = 0.02-0.685; LAT: P = 0.010-0.769; IPE: P = 0.093-0.939; VPE: P = 0.016-1.000). Data Conclusion The rCBV(max) calculated in HAT, LAT, and IPE habitats have been validated as clinically relevant prognostic biomarkers for glioblastoma patients in the pretreatment stage. This study demonstrates the robustness of the hemodynamic tissue signature (HTS) habitats to assess the GBM vascular heterogeneity and their association with patient prognosis independently of intercenter variability. Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019., This work was partially supported by: MTS4up project (National Plan for Scientific and Technical Research and Innovation 2013-2016, No. DPI2016-80054-R) (to J.M.G.G.); H2020-SC1-2016-CNECT Project (No. 727560) (to J.M.G.G.) and H2020-SC1-BHC-2018-2020 (No. 825750) (to J.M.G.G.); M.A.T was supported by DPI2016-80054-R (Programa Estatal de Promocion del Talento y su Empleabilidad en I + D + i). The data acquisition and curation of the Oslo University Hospital was supported by: the European Research Council (ERC) under the European Union's Horizon 2020 (Grant Agreement No. 758657), the South-Eastern Norway Regional Health Authority Grants 2017073 and 2013069, and the Research Council of Norway Grants 261984 (to K.E.E.). We gratefully acknowledge the support of NVIDIA Corporation with the donation of the Titan V GPU used for this research. E.F.G. was supported by the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No. 844646. Figure 1 was designed by the Science Artist Elena Poritskaya.
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- 2020
10. Meningioma Surgery–Are We Making Progress?
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Meling, Torstein R., Da Broi, Michele, Scheie, David, Helseth, Eirik, and Smoll, Nicolas R.
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MENINGIOMA , *LONGITUDINAL method , *ODDS ratio , *MULTIVARIATE analysis , *OLDER patients - Abstract
To study improvements in outcomes after surgery for intracranial meningiomas. We performed a longitudinal observational study comparing 1469 patients operated on for intracranial meningioma in 4 consecutive time frames (1990–1994, 1995–1999, 2000–2004, and 2005–2010). Median age at surgery was 58.3 years. Median follow-up was 7 years. Patients in later periods were older than in the earlier ones (odds ratio [OR], 1.19 [1.09–1.32]; P < 0.0005), indicating a trend toward operating on more elderly patients. Before 2000, 42%, 32%, 6%, 19%, and 0.3% achieved Simpson grade (SG) I, II, III, IV, and V, respectively, whereas the SG rates were 35%, 37%, 4%, 23%, and 0.9% after 2000 (OR, 1.18 [1.06–1.30]; P < 0.005). The perioperative mortality (OR, 0.65 [0.46–0.91]; P < 0.05) and worsened neurologic outcome rate (OR, 0.70 [0.60–0.83]; P < 0.0001) were significantly lower in later decades, but the 4 surgical periods were similar regarding postoperative infections and hematomas. Retreatment-free survival (RFS) and overall survival (OS) increased significantly over the 4 time frames (P < 0.05 and P < 0.0001, respectively). Multivariate analysis confirmed the improvement of surgical radicality, neurologic outcome, perioperative mortality, OS, and RFS. Meningioma surgery as well as patient population changed over the 2 decades considered in this study. We observed higher rates of gross total resection in the later period and the perioperative outcomes improved or were unchanged, which signifies better long-term outcomes, RFS, and OS. [ABSTRACT FROM AUTHOR]
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- 2019
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11. Predictors of Survival in Subtotally Resected WHO Grade I Skull Base Meningiomas.
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Da Broi, Michele, Borrelli, Paola, Meling, Torstein R., Torp, Sverre Helge, and Scheie, David
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HEAD tumors ,SURVIVAL ,AGE distribution ,PREOPERATIVE period ,NEUROSURGERY ,TREATMENT effectiveness ,MENINGIOMA ,DESCRIPTIVE statistics ,REOPERATION ,KARNOFSKY Performance Status ,NECK tumors ,EVALUATION - Abstract
Simple Summary: Radical excision of meningiomas of the skull base has always been a major surgical challenge because of the complex location and the risk of neurovascular damage related to it. In these cases, the benefits of gross-total resection must be balanced with the quality of life after surgery. In the present study, we investigated a cohort of 212 consecutive patients who underwent partial resection of a benign skull base meningioma in order to find predictors of overall survival (OS). Moreover, we analyzed the clinical outcomes and cases of retreatment for progressive disease. In our case series, advanced age at surgery and a preoperative Karnofsky performance status of <70 were negative predictors of OS. Patients who underwent further procedures did not have reduced OS. Overall, surgical and neurological outcomes of STR skull base meningiomas were worse compared to case series, including also completely resected tumors. Background: Although gross total resection (GTR) is the goal in meningioma surgery, this can sometimes be difficult to achieve in skull base meningiomas. We analyzed clinical outcomes and predictors of survival for subtotally resected benign meningiomas. Methods: A total of 212 consecutive patients who underwent subtotal resection (STR) for benign skull base meningioma between 1990–2010 were investigated. Results: Median age was 57.7 [IQR 18.8] years, median preoperative Karnofsky performance status (KPS) was 80.0 [IQR 20.0], 75 patients (35.4%) had posterior fossa meningioma. After a median follow-up of 6.2 [IQR 7.9] years, retreatment (either radiotherapy or repeated surgery) rate was 16% at 1-year, 27% at 3-years, 34% at 5-years, and 38% at 10-years. Ten patients (4.7%) died perioperatively, 9 (3.5%) had postoperative hematomas, and 2 (0.8%) had postoperative infections. Neurological outcome at final visit was improved/stable in 122 patients (70%). Multivariable analysis identified advanced age and preoperative KPS < 70 as negative predictors for overall survival (OS). Patients who underwent retreatment had no significant reduction of OS. Conclusions: Advanced age and preoperative KPS were independent predictors of OS. Retreatments did not prolong nor shorten the OS. Clinical outcomes in STR skull base meningiomas were generally worse compared to cohorts with high rates of GTR. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Efficacy of the Nordic and the MSKCC chemotherapy protocols on the overall and progression-free survival in intracranial PCNSL.
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Da Broi, Michele, Jahr, Guro, Beiske, Klaus, Holte, Harald, and Meling, Torstein R.
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DRUG efficacy , *CANCER chemotherapy , *DISEASE progression , *MULTIVARIATE analysis , *LYMPHOMAS , *PATIENTS - Abstract
Abstract Background To compare the Nordic and the Memorial Sloan-Kettering Cancer Center (MSKCC) chemotherapy protocols for Overall Survival (OS) and Progression-Free Survival (PFS) for intracranial primary CNS lymphoma (PCNSL). Methods A prospective database at Oslo University Hospital of PCNSL was reviewed over a 12-year period (2003–2014). Results Overall, 79 patients with PCNSL were identified, of whom 57 received chemotherapy. MSKCC with Rituximab (RTX) was used in 18 patients (32%) who had median OS of 46.3 months [9.8–131.9] and median PFS of 34.6 months [6.4–131.9]. The Nordic protocol was used in 14 patients (25%) who had median OS of 30.9 months [2.7–106.3] and PFS of 14.3 months [0.0–106.3]. The MSKCC was used without RTX in 25 patients (44%) who had OS of 15.2 months [0.7–136.5] and PFS of 12.0 months [0.0–117.0]. MSKCC with RTX had a significantly longer median OS (p < 0.05) compared to the other regimens in univariate analysis. In multivariate analysis, the only prognostic factor for OS and PFS of significance was deep brain involvement (p < 0.005). Conclusions In univariate analysis, the MSKCC with RTX achieved significantly longer median OS compared to the Nordic protocol. However, in multivariate analysis, the only prognostic factor for survival of statistical significance was deep brain involvement. [ABSTRACT FROM AUTHOR]
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- 2018
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13. Evaluation of Memorial Sloan‐Kettering Cancer Center and International Extranodal Lymphoma Study Group prognostic scoring systems to predict Overall Survival in intracranial Primary CNS lymphoma.
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Jahr, Guro, Broi, Michele Da, Holte, Jr, Harald, Beiske, Klaus, and Meling, Torstein R.
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LYMPHOMAS , *TUMOR grading , *CANCER chemotherapy , *BRAIN surgery , *RECURSIVE partitioning - Abstract
Abstract: Objectives: To evaluate the validity of Memorial Sloan‐Kettering Cancer Center (MSKCC) and International Extranodal Lymphoma Study Group (IELSG) prognostic scoring systems for Overall Survival (OS) in intracranial Primary CNS lymphoma (PCNSL) of all patients diagnosed at a single center. Material and Methods: Pretreatment clinical factors including tumor characteristics and histology, treatment, and survival of PCNSL patients with diagnostic biopsies over a 12‐year period (2003–2014) were retrieved from a prospective database at Oslo University Hospital. Results: Seventy‐nine patients with intracranial PCNSL were identified. The female:male ratio was 1:1.63 and the median age was 65.3 years [range 18.9–80.7]. Involvement of deep brain structures was shown in 63 patients. Six patients were MSKCC risk group 1, 35 patients were in risk group 2, and 38 patients were in risk group 3. International Extranodal Lymphoma Study Group scores were <2 in 17 patients (22%). After a median follow‐up of 70.5 months, 55 patients were dead. Median OS was 16.4 months [range 0.2–157.7]. Age, sLDH by recursive partitioning analysis (RPA), Eastern Cooperative Oncology Group score (ECOG), lesion size, involvement of deep brain structures, IELSG score, and MSKCC score were significant factors for OS in univariate analysis. Multivariate analysis confirmed the significance of age (
p < .05), sLDH by RPA (p < .005), ECOG (p < .05), and deep brain structure involvement (p < .05) for OS. The six‐tiered IELSG scores had to be dichotomized according to RPA analysis into <2 and ≥2 in order to have prognostic value. In contrast, when using the three‐tiered MSKCC, three distinct risk groups were identified. Conclusions: Our study failed to verify the IELSG, but validated the use of MSKCC for prognostication of OS in intracranial PCNSL. [ABSTRACT FROM AUTHOR]- Published
- 2018
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