Artikel
Malignant potential of skull base meningiomas versus non skull base meningiomas – Clinical series of 1740 cases
Suche in Medline nach
Autoren
-
J.F. Cornelius
- Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland
-
P.J. Slotty
- Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland
-
H.J. Steiger
- Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Deutschland
-
M. Polivka
- Service de neuro-pathologie, Hôpital Universitaire Lariboisière, Paris, France
-
B. George
- Service de neurochirurgie, Hôpital Universitaire Lariboisière, Paris, France
| Veröffentlicht: | 4. Juni 2012 |
|---|
Gliederung
Text
Objective: Meningiomas represent up to 30% of primary intracranial tumors and are the most frequent non-glial primary brain tumors. Most meningiomas are benign, however atypical and anaplastic variants exist. WHO grade and localization are important decisional factors for individual treatment strategy. Up to now, correlations between histo-pathological features and anatomical localization have been controversially discussed.
Methods: We present a huge study of surgically treated intracranial meningiomas. The population was retrospectively analyzed for correlations between localization, WHO grading, histological subtypes, patient age and sex. On the basis of prior studies, patients were stratified in age groups (<65 yrs vs. ≥65 yrs) and WHO grading (I° tumors vs. (II° + III°) tumors merged). Statistical testing for goodness of fit, correlation and binary logistic regression was conducted to identify factors influencing occurrence of higher grade tumors.
Results: After exclusion of patients treated for recurrence, previous radiation or chemotherapy and incomplete data-sets 1740 patients remained. Gender ratio was 1357 vs. 383 (78 % vs. 22 %), median age was 54.7 years (SD 12.9 yrs.), WHO grading was I° in 1619, II° in 110 and III° in 11 cases. 664 meningiomas were localized at the skull-base, 560 at the convexity, 516 could not be clearly assigned to one of the groups and omitted in localization analysis. Factors reaching significant level in Chi2-testing were subjected to stepwise binary logistic regression. Non-skullbase localization (p = 0.018, OR 1.70, CI 1.095-2.64) and age > 65 years (p = 0.034, OR 1.644, CI 1.038-2.602) were independent risk factors of having a higher grade meningioma. Male sex did not reach significant levels in logistic regression.
Conclusions: Risk factors of higher grade meningioma are controversially discussed in the literature. Comprising 1740 patients with primarily treated meningiomas this is the largest study on this subject published so far. Age over 65 years and non-skullbase localization were independent risk factors of having a higher grade meningioma.
