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Multicentric and diffuse recurrences of meningiomas.
- Source :
-
British journal of neurosurgery [Br J Neurosurg] 2020 Aug; Vol. 34 (4), pp. 439-446. Date of Electronic Publication: 2020 Apr 21. - Publication Year :
- 2020
-
Abstract
- Background: Meningiomas recur with a rate of 10-32% at 10 years. Several features influence the risk of recurrence. Objective: To define the pathological and surgical features at risk of multicentric-diffuse versus local-peripheral recurrence. Methods: Thirty-three patients operated on for intracranial meningiomas who experienced multicentric-diffuse recurrence were retrospectively analyzed. The data of these patients were compared to those of 50 patients who experienced local-peripheral recurrence. The analyzed factors included age and sex, tumor location and shape, brain-tumor interface, entity of resection, WHO grade, Ki67 MIB1, progesterone receptor (PR) expression, number of reoperations, progression of WHO grade, and outcome. Results: Meningiomas which recurred in multicentric-diffuse pattern showed at initial surgery a significantly higher rate of flat-shaped tumors ( p = .0008) and of cases with Ki67 Li ≥ 4% ( p = .037) than those which recurred in localized-peripheral pattern, whereas other factors did not significantly differ. Among patients with multicentric-diffuse recurrences, 25 underwent one to three reoperations; 17 among them (66%) are alive with local tumor control or slow progression 2-25 years after the initial surgery versus only 2 out of 8 who did not undergo surgery. Conclusions: Flat-shaped meningiomas and those with Ki67 Li ≥ 4% are at higher risk of multicentric-diffuse recurrence. Multiple reoperations over a period of several years may obtain rather long survivals in selected patients with prevalent intradural, not anaplastic tumors and not too extensive dural infiltration.
Details
- Language :
- English
- ISSN :
- 1360-046X
- Volume :
- 34
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- British journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 32312105
- Full Text :
- https://doi.org/10.1080/02688697.2020.1754335