gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Determinants of long-term tumor control for atypical and anaplastic meningiomas

Meeting Abstract

  • J.P. Zeden - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald, Greifswald
  • J. Baldauf - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald, Greifswald
  • M.J. Fritsch - Klinik für Neurochirurgie, Dietrich Bonhoeffer-Klinikum, Neubrandenburg
  • C. Rosenstengel - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald, Greifswald
  • S. Vogelgesang - Institut für Pathologie, Universitätsklinikum Greifswald, Greifswald
  • H.W.S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Greifswald, Greifswald

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.03.02

DOI: 10.3205/12dgnc038, URN: urn:nbn:de:0183-12dgnc0384

Published: June 4, 2012

© 2012 Zeden et al.
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Outline

Text

Objective: The clinical course of atypical and anaplastic meningiomas (AM) after initial gross total resection is heterogeneous and the optimal management is unclear. The aim of the study was to evaluate long-term recurrence rates, factors predicting recurrence and the outcome between de novo malignant meningiomas and meningiomas that progressed to malignancy apart from key determinates for recurrence of these tumors being extent of resection and histological grade.

Methods: We performed a retrospective review of 37 AMs that were managed at our institution between 2000 and 2011 with histologically confirmed atypical or anaplastic meningioma (pathology grading according to the World Health Organization 2000 guidelines). 9 of 38 patients had already been treated for the tumor before 2000. We analyzed data concerning patients' sex, age, tumor location, number of operations, extent of resection (Simpson grade), additional therapy and survival. For meningiomas with progression, we assessed the interval between operation and tumor progression or recurrence after grouping for Simpson grade of resection and postoperative radiation.

Results: Clinical data of 17 female and 20 male accounted for 279 years of follow-up. The median follow-up time was 60 months (range 3–388). The study group consisted of 30 patients with WHO °II tumors and 7 patients with WHO °III tumors. For gross total resection (Simpson grade I) the mean interval to recurrence was 64 months (n = 17) for WHO °II and 11 months (n = 7) for WHO °III tumors. Patients with recurrent tumor had 3.75 craniotomies on average (range 2 - 8). Radiation therapy for 11 of 15 recurrent tumors did increase the mean recurrence free interval from 34 (time to recurrence after Simpson > 1 resection, n = 7) to 40 months (time to recurrence after radiation, n = 3) for WHO °II tumors and from 5.4 (time to recurrence after Simpson > 1 resection, n = 5) to 29 (time to recurrence after radiation, n = 3) months for WHO °III tumors. Ten re-resected meningiomas underwent transformations from lower grade tumors.

Conclusions: AMs have a high recurrence rate despite gross total resection. Although postoperative radiation is known to increase the progression free interval, the long-term result with recurrent meningiomas is mainly dependent from factors that determine operability.