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11.11.2019 | Clinical Study

Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome

verfasst von: Annamaria Biczok, Christine Jungk, Rupert Egensperger, Andreas von Deimling, Bogdana Suchorska, Joerg C. Tonn, Christel Herold-Mende, Christian Schichor

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2019

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Abstract

Purpose

For meningiomas, the 2016 revision of the WHO classification introduced brain invasion per se as a sufficient condition to classify as grade II. We analyzed whether meningiomas previously graded as WHO grade I differ in prognosis depending on the presence of microscopic brain invasion.

Methods

A consecutive series of patients with intracranial meningioma WHO grade I (± brain invasion) at two neurosurgical departments was analyzed retrospectively. Cox regression models on progression-free survival (PFS) and Kaplan–Meier survival estimates were performed.

Results

875 adult patients were included. Histological diagnosis of brain invasion was confirmed in 28 patients. Median follow-up was 73 months. In univariate and multivariate models, gross total resection gained favorable prognostic influence for PFS (p < 0.001, HR: 0.237, CI 0.170–0.382). 170 patients with the brain/meningioma interface present in histopathological specimen were separately analyzed as a subgroup. Importantly, presence of brain invasion did not reach significance for PFS, even in the subgroup with available specimen of brain/meningioma interface (p = 0.787, HR: 0.852, CI 0.268–2.710 and p = 0.811, HR: 0.848, CI 0.222–3.246, respectively). Patients with and without brain invasion did not differ in terms of age, tumor location and extent of resection, but were more likely to receive radiotherapy (p = 0.03) of tumor remnants. However, subgroup analysis of non-irradiated tumors revealed no prognostic influence of brain invasion (p = 0.749, HR: 0.772, CI 0.158–3.767).

Conclusions

In this bi-institutional series, brain invasion was frequent among meningiomas WHO grade I when brain/meningioma interface was available for histology (16.5%). However, brain invasion did not impact early recurrence.

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Gittleman HR, Ostrom QT, Rouse CD, Dowling JA, de Blank PM, Kruchko CA, Elder JB, Rosenfeld SS, Selman WR, Sloan AE, Barnholtz-Sloan JS (2015) Trends in central nervous system tumor incidence relative to other common cancers in adults, adolescents, and children in the United States, 2000 to 2010. Cancer 121:102–112. https://doi.org/10.1002/cncr.29015 CrossRefPubMed

Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS (2018) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro Oncology https://doi.org/10.1093/neuonc/noy131 CrossRefPubMedPubMedCentral

Achey RL, Gittleman H, Schroer J, Khanna V, Kruchko C, Barnholtz-Sloan JS (2018) Nonmalignant and malignant meningioma incidence and survival in the elderly, 2005–2015, using the Central Brain Tumor Registry of the United States. Neuro-Oncology 21(3):380–391. https://doi.org/10.1093/neuonc/noy162 CrossRefPubMedCentral

Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, von Deimling A, Stavrinou P, Lefranc F, Lund-Johansen M, Moyal EC, Brandsma D, Henriksson R, Soffietti R, Weller M (2016) EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17:e383–391. https://doi.org/10.1016/S1470-2045(16)30321-7 CrossRefPubMed

Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1 CrossRefPubMed

Ildan F, Erman T, Gocer AI, Tuna M, Bagdatoglu H, Cetinalp E, Burgut R (2007) Predicting the probability of meningioma recurrence in the preoperative and early postoperative period: a multivariate analysis in the midterm follow-up. Skull Base 17:157–171. https://doi.org/10.1055/s-2007-970554 CrossRefPubMedPubMedCentral

Lam Shin Cheung V, Kim A, Sahgal A, Das S (2018) Meningioma recurrence rates following treatment: a systematic analysis. J Neurooncol 136:351–361. https://doi.org/10.1007/s11060-017-2659-6 CrossRefPubMed

Gousias K, Schramm J, Simon M (2016) The simpson grading revisited: aggressive surgery and its place in modern meningioma management. J Neurosurg 125:551–560. https://doi.org/10.3171/2015.9.JNS15754 CrossRefPubMed

Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC (1999) "Malignancy" in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer 85:2046–2056PubMed

10.

Perry A, Stafford SL, Scheithauer BW, Suman VJ, Lohse CM (1997) Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol 21:1455–1465CrossRefPubMed

11.

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109. https://doi.org/10.1007/s00401-007-0243-4 CrossRefPubMedPubMedCentral

12.

Brokinkel B, Hess K, Mawrin C (2017) Brain invasion in meningiomas-clinical considerations and impact of neuropathological evaluation: a systematic review. Neuro Oncol 19:1298–1307. https://doi.org/10.1093/neuonc/nox071 CrossRefPubMedPubMedCentral

13.

Sun SQ, Cai C, Murphy RK, DeWees T, Dacey RG, Grubb RL, Rich KM, Zipfel GJ, Dowling JL, Leuthardt EC, Simpson JR, Robinson CG, Chicoine MR, Perrin RJ, Huang J, Kim AH (2016) Radiation therapy for residual or recurrent atypical meningioma: the effects of modality, timing, and tumor pathology on long-term outcomes. Neurosurgery 79:23–32. https://doi.org/10.1227/NEU.0000000000001160 CrossRefPubMed

14.

Pizem J, Velnar T, Prestor B, Mlakar J, Popovic M (2014) Brain invasion assessability in meningiomas is related to meningioma size and grade, and can be improved by extensive sampling of the surgically removed meningioma specimen. Clin Neuropathol 33:354–363. https://doi.org/10.5414/NP300750 CrossRefPubMed

15.

Spille DC, Hess K, Sauerland C, Sanai N, Stummer W, Paulus W, Brokinkel B (2016) Brain invasion in meningiomas: incidence and correlations with clinical variables and prognosis. World Neurosurg 93:346–354. https://doi.org/10.1016/j.wneu.2016.06.055 CrossRefPubMed

16.

Baumgarten P, Gessler F, Schittenhelm J, Skardelly M, Tews DS, Senft C, Dunst M, Imoehl L, Plate KH, Wagner M, Steinbach JP, Seifert V, Mittelbronn M, Harter PN (2016) Brain invasion in otherwise benign meningiomas does not predict tumor recurrence. Acta Neuropathol 132:479–481. https://doi.org/10.1007/s00401-016-1598-1 CrossRefPubMed

17.

Streckert EMS, Hess K, Sporns PB, Adeli A, Brokinkel C, Kriz J, Holling M, Eich HT, Paulus W, Spille DC, van Eck A, Raleigh DR, McDermott MW, Stummer W, Brokinkel B (2019) Clinical, radiological, and histopathological predictors for long-term prognosis after surgery for atypical meningiomas. Acta Neurochir. https://doi.org/10.1007/s00701-019-03956-8 CrossRefPubMed

18.

Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39. https://doi.org/10.1136/jnnp.20.1.22 CrossRefPubMedPubMedCentral

19.

Rogers L, Barani I, Chamberlain M, Kaley T, McDermott M, Raizer J, Schiff D, Weber DC, Wen PY, Vogelbaum MA (2015) Meningiomas: knowledge base, treatment outcomes, and uncertainties: a rano review. J Neurosurg 122:4–23. https://doi.org/10.3171/2014.7.JNS131644 CrossRefPubMedPubMedCentral

20.

Huang RY, Bi WL, Weller M, Kaley T, Blakeley J, Dunn I, Galanis E, Preusser M, McDermott M, Rogers L, Raizer J, Schiff D, Soffietti R, Tonn JC, Vogelbaum M, Weber D, Reardon DA, Wen PY (2019) Proposed response assessment and endpoints for meningioma clinical trials: report from the Response Assessment in Neuro-Oncology Working Group. Neuro Oncol 21:26–36. https://doi.org/10.1093/neuonc/noy137 CrossRefPubMed

21.

Ma J, Cheng L, Wang G, Lin S (2014) Surgical management of meningioma of the trigone area of the lateral ventricle. World Neurosurg 82:757–769. https://doi.org/10.1016/j.wneu.2014.05.026 CrossRefPubMed

22.

Bloss HG, Proescholdt MA, Mayer C, Schreyer AG, Brawanski A (2010) Growth pattern analysis of sphenoid wing meningiomas. Acta Neurochir 152(1):99–103. https://doi.org/10.1007/s00701-009-0556-2 CrossRefPubMed

23.

Mantle RE, Lach B, Delgado MR, Baeesa S, Belanger G (1999) Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning. J Neurosurg 91:375–383. https://doi.org/10.3171/jns.1999.91.3.0375 CrossRefPubMed

24.

Sun SQ, Kim AH, Cai C, Murphy RK, DeWees T, Sylvester P, Dacey RG, Grubb RL, Rich KM, Zipfel GJ, Dowling JL, Leuthardt EC, Leonard JR, Evans J, Simpson JR, Robinson CG, Perrin RJ, Huang J, Chicoine MR (2014) Management of atypical cranial meningiomas, part 1: predictors of recurrence and the role of adjuvant radiation after gross total resection. Neurosurgery 75(4):347–354. https://doi.org/10.1227/NEU.0000000000000461 CrossRefPubMed

25.

Backer-Grondahl T, Moen BH, Arnli MB, Torseth K, Torp SH (2014) Immunohistochemical characterization of brain-invasive meningiomas. Int J Clin Exp Pathol 7:7206–7219PubMedPubMedCentral

26.

Brokinkel B, Stummer W (2016) Brain invasion in meningiomas: the rising importance of a uniform neuropathologic assessment after the release of the 2016 World Health Organization classification of central nervous system tumors. World Neurosurg 95:614–615. https://doi.org/10.1016/j.wneu.2016.08.047 CrossRefPubMed

27.

Timme M, Thomas C, Spille DC, Stummer W, Ebel H, Ewelt C, Hans F-J, Schick U, Puchner M, Wildförster U, Bruns B, Trost HA, Holling M, Grauer O, Hess K, Brokinkel B (2019) Brain invasion in meningiomas: does surgical sampling impact specimen characteristics and histology? Neurosurg Rev. https://doi.org/10.1007/s10143-019-01125-0 CrossRefPubMed

28.

Pereira BJA, de Almeida AN, Paiva WS, Teixeira MJ, Marie SKN (2018) Impact of radiotherapy in atypical meningioma recurrence: literature review. Neurosurg Rev. https://doi.org/10.1007/s10143-018-0959-8 CrossRefPubMed

29.

Park HJ, Kang HC, Kim IH, Park SH, Kim DG, Park CK, Paek SH, Jung HW (2013) The role of adjuvant radiotherapy in atypical meningioma. J Neurooncol 115:241–247. https://doi.org/10.1007/s11060-013-1219-y CrossRefPubMed

30.

Weber DC, Ares C, Villa S, Peerdeman SM, Renard L, Baumert BG, Lucas A, Veninga T, Pica A, Jefferies S, Ricardi U, Miralbell R, Stelmes JJ, Liu Y, Collette L, Collette S (2018) Adjuvant postoperative high-dose radiotherapy for atypical and malignant meningioma: A phase-II parallel non-randomized and observation study (EORTC 22042–26042). Radiother Oncol 128:260–265. https://doi.org/10.1016/j.radonc.2018.06.018 CrossRefPubMed

31.

Sahm F, Schrimpf D, Stichel D, Jones DTW, Hielscher T, Schefzyk S, Okonechnikov K, Koelsche C, Reuss DE, Capper D, Sturm D, Wirsching H-G, Berghoff AS, Baumgarten P, Kratz A, Huang K, Wefers AK, Hovestadt V, Sill M, Ellis HP, Kurian KM et al. (2017) DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. Lancet Oncol 18(5), 682–694. https://doi.org/10.1016/S1470-2045(17)30155-9 CrossRefPubMed

32.

Sahm F, Schrimpf D, Olar A, Koelsche C, Reuss D, Bissel J, Kratz A, Capper D, Schefzyk S, Hielscher T, Wang Q, Sulman EP, Adeberg S, Koch A, Okuducu AF, Brehmer S, Schittenhelm J, Becker A, Brokinkel B, Schmidt M, Ull T, Gousias K, Kessler AF, Lamszus K, Debus J, Mawrin C, Kim YJ, Simon M, Ketter R, Paulus W, Aldape KD, Herold-Mende C, von Deimling A (2016) TERT promoter mutations and risk of recurrence in meningioma. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djv377 CrossRefPubMed

33.

Biczok A, Kraus T, Suchorska B, Terpolilli NA, Thorsteinsdottir J, Giese A, Tonn JC, Schichor C (2018) TERT promoter mutation is associated with worse prognosis in WHO grade II and III meningiomas. J Neurooncol 139:671–678. https://doi.org/10.1007/s11060-018-2912-7 CrossRefPubMed

34.

Furtjes G, Kochling M, Peetz-Dienhart S, Wagner A, Hess K, Hasselblatt M, Senner V, Stummer W, Paulus W, Brokinkel B (2016) hTERT promoter methylation in meningiomas and central nervous hemangiopericytomas. J Neurooncol 130:79–87. https://doi.org/10.1007/s11060-016-2226-6 CrossRefPubMed

Titel: Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome
verfasst von: Annamaria Biczok
Christine Jungk
Rupert Egensperger
Andreas von Deimling
Bogdana Suchorska
Joerg C. Tonn
Christel Herold-Mende
Christian Schichor
Publikationsdatum: 11.11.2019
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03312-x

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Microscopic brain invasion in meningiomas previously classified as WHO grade I is not associated with patient outcome

Abstract

Purpose

Methods

Results

Conclusions

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Purpose

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