MNGI-36. BRAIN INVASION IN MENINGIOMAS PREVIOUSLY CLASSIFIED AS WHO GRADE I HAS LIMITED IMPACT ON OUTCOME. (5th November 2018)

• Record Type: Journal Article
• Authors: Biczok, Annamaria; Suchorska, Bogdana; Egensperger, Rupert; Tonn, Jörg-Christian; Schichor, Christian
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 6
• Page Start: vi156
• Page End: vi157
• Publication Date: 2018-11-05
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy148.652
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: INTRODUCTION: The revision of the WHO classification in 2016 introduced brain invasion as a per se sufficient condition for meningiomas to be classified as grade II. We analyzed whether meningiomas previously graded as WHO grade I according to the 2007 version differ in prognosis solely according to the feature of brain invasion. METHODS: From 1/2009 - 03/2016 all consecutive patients with surgery of a meningioma WHO grade I (2007 grading system) were included. Reference point of the study was date of surgery. Brain invasion was re-evaluated in all cases by a neuropathologist being blinded for the clinical course. Date of last follow up was 11/2017. Study endpoint was the date of tumor progression. Prognostic factors were obtained from multivariate proportional hazards models. RESULTS: 949 adult patients were included. Median follow-up was 43 months (range: 3–78 months). Gross total resection (GTR) was achieved in 719 (75.8%) patients, adjuvant radiotherapy was applied in 91 (9.9%) patients. Brain invasion was diagnosed by histology in 24 (2.5%) patients. Patients with/without brain invasion did not differ in terms of age and extent of resection. Patients with histologically proven brain invasion received more often adjuvant radiotherapy (p=0.02). 88 patients experienced tumor recurrence, overall survival was not reached in the majority of patients. The overall median PFS for patients with (without) brain invasion was 22 (23) months (p=0.48). In Subtotal resection and history of another malignancy were associated with shorter PFS in univariate and multivariate models (p<0.001), but neither brain invasion nor radiotherapy. CONCLUSION: Among meningiomas classified as grade I according to the WHO 2007 grading system, histological proven brain invasion is rare and was not associated with worse prognosis in contrast to extent of resection and history of another malignancy. However, whether postoperative radiotherapy might have been beneficial for these patients has to be analysed prospectively.