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Erschienen in: Journal of Neuro-Oncology 3/2017

19.05.2017 | Clinical Study

The Simpson grading in meningioma surgery: does the tumor location influence the prognostic value?

verfasst von: Kira Marie Voß, Dorothee Cäcilia Spille, Cristina Sauerland, Eric Suero Molina, Caroline Brokinkel, Werner Paulus, Walter Stummer, Markus Holling, Astrid Jeibmann, Benjamin Brokinkel

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2017

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Abstract

In meningiomas, location-specific differences of the prognostic value of the Simpson classification are sparsely investigated but can influence strategy of surgery. We therefore compared the prognostic value of the Simpson classification in different tumor locations. Progression was compared with Simpson grade in 826 meningioma patients (median age 58 years, female:male ratio 2.4) in location-specific uni- and multivariate analyses. Simpson grade strongly correlated with tumor location (p < .001). Within a median follow-up of 50 months, recurrence was observed in 107 of 803 patients (13%). In general, increasing Simpson grade (p = .002) and subtotal resection (STR, ≥grade III) were correlated with tumor recurrence [hazard ratio (HR): 1.87; p = .004]. In 268 convexity meningiomas, frequency of tumor recurrence correlated with Simpson grade (p = .034). Risk of recurrence was similar after grade I and II resections, tended to increase after grade III (HR: 2.35; p = .087) but was higher after grade IV resections (HR: 7.35; p = .003). Risk of recurrence was higher after STR (HR: 4.21; p = .001) than after gross total resection (GTR, ≤grade II). Contrarily, increasing Simpson grade and STR were not correlated with progression in 102 falx, 38 posterior fossa and nine intraventricular meningiomas. In 325 skull base lesions, risk of recurrence was similar after GTR and STR (p = .198) and was only increased after grade IV resections (HR: 3.26; p = .017). Simpson grading and extent of resection were not equally prognostic in all locations. Lower impact of extent of resection should be considered during surgery for skull base, posterior fossa and falx meningiomas.
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Metadaten
Titel
The Simpson grading in meningioma surgery: does the tumor location influence the prognostic value?
verfasst von
Kira Marie Voß
Dorothee Cäcilia Spille
Cristina Sauerland
Eric Suero Molina
Caroline Brokinkel
Werner Paulus
Walter Stummer
Markus Holling
Astrid Jeibmann
Benjamin Brokinkel
Publikationsdatum
19.05.2017
Verlag
Springer US
Erschienen in
Journal of Neuro-Oncology / Ausgabe 3/2017
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-017-2481-1

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