gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Proliferative potential and the inflammatory tumour microenvironment in meningioma correlate with neurological function at presentation, and anatomical location – from convexity to skull base and spine

Proliferationspotenzial und inflammatorisches Tumormikromilieu in Meninigomen korrelieren mit der initialen neurologischen Funktion und der anatomischen Lokalisation: Von der Konvexität über die Schädelbasis bis zur Wirbelsäule

Meeting Abstract

  • presenting/speaker Johannes Wach - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Tim Lampmann - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Ági Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Ulrich Herrlinger - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Albert Becker - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Michael Hölzel - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Marieta Toma - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV307

doi: 10.3205/22dgnc295, urn:nbn:de:0183-22dgnc2951

Published: May 25, 2022

© 2022 Wach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Emerging evidence emphasizes the prognostic importance of meningioma location. The present investigation evaluates whether progression-free survival (PFS), proliferative potential, WHO grades, and inflammatory burden differ between anatomical locations (skull base, non-skull base, and spinal) meningiomas.

Methods: Five-hundred-forty-one cranial and spinal meningioma patients underwent Simpson grade I or II resection for WHO grade 1 or 2 meningiomas. The inclusion criteria of this study were histopathologically confirmed meningioma, an age greater than 18 years, the availability of neuropathology reports (MIB-I, mitotic count, CD68+ staining), and serum as well as plasma inflammatory laboratory values (fibrinogen & C-reactive protein).

Results: Univariable analysis revealed that spinal meningioma patients are significantly older, had a worse baseline Karnofsky Performance Status (KPS), higher acute-phase protein levels, lower incidence of WHO grade 2, lower mitotic counts, lower MIB-1 indices, and less CD68+ macrophage infiltrates. Furthermore, location-specific meningioma deficits such as seizure burden, cranial nerve deficits, and ambulatory ability were significantly associated with the MIB-1 indices in convexity, skull base, and spinal meningiomas. Multivariable analysis identified WHO grade 2 (OR:2.1, 95%CI: 1.1-3.7, p=0.02) and cranial location (OR:3.0, 95%CI: 1.8-4.9, p=0.001) as independent predictors of diffuse CD68+ macrophage infiltrates. The mean PFS in cranial meningiomas was 115.9 months (95%CI: 107.5-124.3), compared to 162.2 months (95%CI: 150.5-174.0; log-rank test: p=0.02) in spinal meningiomas. Multivariable Cox regression analysis revealed cranial location as an independent predictor (HR:4.7, 95%CI: 1.0-21.3, p=0.04) of shortened PFS.

Conclusion: Increased MIB-1 indices ≥5% were significantly associated with location-specific deficits at presentation such as decreased vision and seizure burden. Spinal meningiomas have a significantly longer PFS time and differ from the cranial meningiomas regarding MIB-1 index and density of tumor-associated macrophages.