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Neurosurg Rev. 2019 Jun 10. doi: 10.1007/s10143-019-01117-0. [Epub ahead of print]

WHO grade I meningiomas: classification-tree for prognostic factors of survival.

Author information

1
Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland. lemee.jmichel@wanadoo.fr.
2
Service de Neurochirurgie, Hôpitaux Universitaires de Genève, Rue Gabriel-Perret-Gentil 5, 1205, Genève, Switzerland. lemee.jmichel@wanadoo.fr.
3
Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland.
4
Faculty of Medicine, University of Oslo, Oslo, Norway.
5
Section of Neuropathology, Rigshospitalet, Copenhagen, Denmark.
6
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
7
Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.

Abstract

World Health Organization (WHO) grade I meningiomas are intracranial extracerebral tumors, in which microsurgery as a stand-alone therapy provides high rates of disease control and low recurrence rates. Our aim was to identify prognostic factors of overall survival and time-to-retreat (OS; TTR) in a cohort of patients with surgically managed WHO grade I meningioma. Patients with WHO grade I meningiomas from a retrospectively (1990 to 2002) and prospectively managed (2003 to 2010) databank of Oslo University Hospital, Norway, were included. The mean follow-up was 9.2 ± 5.7 years, with a total of 11,414 patient-years. One thousand three hundred fifty-five patients were included. The mean age was 58 ± 13.2, mean Karnofsky Performance Status (KPS) 92.6 ± 26.1 and female-to-male ratio 2.5:1. The 1-year, 5-year, 10-year, 15-year, and 20-year probabilities were 0.98, 0.91, 0.87, 0.84, and 0.8 for TTR. Patient age (OR 0.92 [0.91, 0.94]), male sex (OR 0.59 [0.45, 0.76]), preoperative KPS ≥ 70 (OR 2.22 [1.59, 3.13]), skull base location (OR 0.77 [0.60, 1]), and the occurrence of a postoperative hematoma (OR 0.44 [0.26, 0.76]) were identified as independent prognostic factors of OS. Patient age (OR 1.02 [1.01, 1.03]) and skull base location (OR 0.30 [0.21, 0.45]) were independent predictors of decreased PFS. Using a recursive partitioning analysis, we suggest a classification tree for the prediction of 5-year PFS based on patient and tumor characteristics. The findings from this cohort of meningioma WHO I patients helps to identify patients at risk of recurrence and tailor the therapeutic management.

KEYWORDS:

Meningioma; Overall survival; Prognostic factors; Time-to-retreat; WHO grade I

PMID:
31183587
DOI:
10.1007/s10143-019-01117-0

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