Prognostic factors and the management of anaplastic meningioma

•Postoperative radiotherapy was significantly associated with longer progression-free survival and overall survival.•Gross-total resection was a favourable factor for progression-free survival and overall survival.•Homogeneous contrast on magnetic resonance imaging may be a better prognostic factor...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2018-07, Vol.170, p.13-19
Main Authors: Zhang, Gui-Jun, Zhang, Yun-Sheng, Zhang, Guo-Bin, Li, Da, Zhang, Li-Wei, Wu, Zhen, Zhang, Jun-Ting
Format: Article
Language:English
Subjects:
Age
Anaplastic meningioma
Brain cancer
Gender
Management
Medical prognosis
Meningioma
Metastasis
Multivariate analysis
Neurology
NMR
Nuclear magnetic resonance
Pathogenesis
Patients
Prognosis
Radiation therapy
Surgery
Survival
Treatment
Tumor progression
Tumors
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Summary:•Postoperative radiotherapy was significantly associated with longer progression-free survival and overall survival.•Gross-total resection was a favourable factor for progression-free survival and overall survival.•Homogeneous contrast on magnetic resonance imaging may be a better prognostic factor for progression-free survival. Anaplastic meningiomas (AMs)tend to have a higher local recurrence rate and metastasize. but few studies have reported on the prognosis and management of patients with AM, this study aimed to increase the understanding of the prognosis, management and history of AM. All patients (n = 56) underwent surgeries in our hospital between December 2008 and January 2016. Postoperative pathology reports confirmed the diagnosis of AM. Prognostic factors and the management were analysed in this study. AM was then divided into two groups. One group was primary AM, the other group was secondary AM. Of all the 56 AM patients, 31 were male and 25 were female (male to female ratio of 1.24:1). The 1-, 3-, and 5-year progression-free survival (PFS) rates were 78.6%, 41.1% and 29.7%, respectively, and the corresponding overall survival (OS) rates were 82.1%, 50.1% and 45.0%, respectively. Homogeneous contrast might be a potential better prognostic factor for PFS (HR = 1.824, P = 0.083). Treatment with postoperative radiotherapy (PRT) was significantly associated with longer PFS (HR = 0.390, P = 0.007) and OS (HR = 0.376, P = 0.008) according to univariate analysis. Gross-total resection (GTR) was a favourable factor for PFS (HR = 2.059, P = 0.035) and OS (HR = 2.802, P = 0.004). Achieving GTR is a favourable treatment strategy for patients with AM in our study and patients receiving PRT after resection is essential.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2018.03.028