CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Cohort Characteristics
2.2. Univariate Analysis of Established Prognostic Factors
2.3. Univariate Analysis of CNS Invasion
2.4. Multivariate Analysis
2.5. Predictive Score
3. Discussion
4. Materials and Methods
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Complete Cohort | 5-Year Follow-Up Cohort | ||||||
---|---|---|---|---|---|---|---|---|
N (%) | Tumor Recurrence n (%) | p-Value | N (%) | Tumor Recurrence n (%) | p-Value | |||
Yes | No | Yes | No | |||||
Gender | ||||||||
Female | 1115 (73.5) | 149 (13.4) | 966 (86.6) | <0.0001 * | 391 (71.1) | 149 (38.1) | 242 (61.9) | <0.0001 * |
Male | 402 (26.5) | 93 (23.1) | 309 (76.9) | 159 (28.9) | 93 (58.5) | 66 (41.5) | ||
Tumor localization | ||||||||
Skull base | 788 (51.9) | 139 (17.6) | 649 (82.4) | <0.0001 * | 296 (53.8) | 139 (47.0) | 157 (53.0) | 0.0032 * |
Convexity/falx | 574 (37.8) | 98 (17.1) | 476 (82.9) | 222 (40.4) | 98 (44.1) | 124 (55.9) | ||
Spinal | 155 (10.2) | 5 (3.2) | 150 (96.8) | 32 (5.8) | 5 (15.6) | 27 (84.4) | ||
Simpson grade | ||||||||
1 | 366 (24.8) | 40 (10.9) | 326 (89.1) | <0.0001 * | 120 (22.6) | 40 (33.3) | 80 (66.7) | <0.0001 * |
2 | 411 (27.8) | 27 (6.6) | 384 (93.4) | 105 (19.7) | 27 (25.7) | 78 (74.3) | ||
3 | 308 (20.8) | 48 (15.6) | 260 (84.4) | 112 (21.1) | 48 (42.9) | 64 (57.1) | ||
4 | 393 (26.6) | 122 (31.0) | 271 (69.0) | 195 (36.7) | 122 (62.6) | 73 (37.4) | ||
5 | 0 (-) | 0 (-) | 0 (-) | 0 (-) | 0 (-) | 0 (-) | ||
CNS invasion by histopathological assessment alone | ||||||||
Yes | 73 (4.8) | 26 (35.6) | 47 (64.4) | <0.0001 * | 36 (6.6) | 26 (72.2) | 10 (27.8) | 0.0004 * |
No | 1444 (95.2) | 216 (15.0) | 1228 (85.0) | 514 (93.5) | 216 (42.0) | 298 (58.0) | ||
CNS invasion by intraoperative assessment alone | ||||||||
Yes | 345 (23.7) | 76 (22.0) | 269 (78.0) | 0.0002 * | 136 (26.4) | 76 (55.9) | 60 (44.1) | 0.0011 * |
No | 1110 (76.3) | 151 (13.6) | 959 (86.4) | 380 (73.6) | 151 (39.7) | 229 (60.3) | ||
CNS invasion by combined assessment | ||||||||
Yes | 372 (25.6) | 85 (22.9) | 287 (77.2) | <0.0001 * | 149 (28.9) | 85 (57.1) | 64 (43.0) | 0.0001 * |
No | 1083 (74.4) | 142 (13.1) | 941 (86.9) | 367 (71.1) | 142 (38.7) | 225 (61.3) | ||
CNS invasion intraoperatively not seen on histopathology | ||||||||
Yes | 299 (20.6) | 59 (19.7) | 240 (80.3) | 0.0272 * | 113 (21.9) | 59 (52.2) | 54 (47.8) | 0.0464 * |
No | 1156 (79.5) | 168 (14.5) | 988 (85.5) | 403 (78.1) | 168 (41.7) | 235 (58.3) | ||
CNS invasion double positive (histopathology and intraoperatively) | ||||||||
Yes | 46 (3.2) | 17 (37.0) | 29 (63.0) | <0.0001 * | 23 (4.5) | 17 (73.9) | 6 (26.1) | 0.0031 * |
No | 1409 (96.8) | 210 (14.9) | 1199 (85.1) | 493 (95.5) | 210 (42.6) | 283 (57.4) | ||
WHO classification 2007 | ||||||||
I | 1313 (86.6) | 166 (12.6) | 1147 (87.4) | <0.0001 * | 437 (79.5) | 166 (38.0) | 271 (62.0) | <0.0001 * |
II | 200 (13.2) | 74 (37) | 126 (63) | 110 (20.0) | 74 (67.3) | 36 (32.7) | ||
III | 4 (0.3) | 2 (50) | 2 (50) | 3 (0.6) | 2 (66.7) | 1 (33.3) | ||
WHO classification 2016 | ||||||||
I | 1281 (84.4) | 158 (12.3) | 1123 (87.7) | <0.0001 * | 425 (77.3) | 158 (37.2) | 267 (62.8) | <0.0001 * |
II | 232 (15.3) | 82 (35.3) | 150 (64.7) | 122 (22.2) | 82 (67.2) | 40 (32.8) | ||
III | 4 (0.3) | 2 (50) | 2 (50) | 3 (0.56) | 2 (66.7) | 1 (33.3) |
Variable | Histopathology | Intraoperative | ||
---|---|---|---|---|
Risk Ratio (95% CI) | p-Value (Prob > Chisq) | Risk Ratio (95% CI) | p-Value (Prob > Chisq) | |
Male gender | 1.38 (1.05–1.82) | 0.0227 * | 1.33 (1.00–1.77) | 0.0474 * |
Localization | ||||
Spinal vs. skull base | 0.42 (0.17–1.02) | 0.0562 | 0.45 (0.18–1.10) | 0.0803 |
Spinal vs. convexity/falx | 0.56 (0.22–1.38) | 0.2084 | 0.62 (0.24–1.54) | 0.3009 |
Convexity/falx vs. skull base | 0.75 (0.56–0.99) | 0.0430 * | 0.73 (0.54–0.99) | 0.0411 * |
Simpson grade </= 3 | 0.42 (0.32–0.55) | <0.0001 * | 0.40 (0.30–0.52) | <0.0001 * |
WHO classification 2007 | ||||
I vs. II | 0.40 (0.29–0.56) | <0.0001 * | 0.44 (0.32–0.60) | <0.0001 * |
I vs. III | 0.19 (0.05–0.80) | 0.0239 * | 0.17 (0.04–0.73) | 0.0169 * |
II vs. III | 0.48 (0.12–1.99) | 0.311 | 0.40 (0.10–1.66) | 0.2062 |
CNS invasion by histopathological/intraoperative assessment | 1.11 (0.70–1.76) | 0.6551 | 1.34 (0.99–1.82) | 0.0613 |
Variable | Risk Ratio (95%CI) | p-Value (Prob > Chisq) |
---|---|---|
Male gender | 1.32 (1.00–1.75) | 0.0541 |
Localization | ||
Spinal vs. skull base | 0.45 (0.19–1.12) | 0.0862 |
Spinal vs. convexity/falx | 0.62 (0.24–1.55) | 0.3022 |
Convexity/falx vs. skull base | 0.74 (0.55–1.00) | 0.0447 * |
Simpson grade </= 3 | 0.40 (0.31–0.53) | <0.0001 * |
WHO classification 2007 | ||
I vs. II | 0.45 (0.33–0.63) | <0.0001 * |
I vs. III | 0.17 (0.04–0.73) | 0.0167 * |
II vs. III | 0.38 (0.09–1.61) | 0.1894 |
CNS invasion by combined assessment (histology and intraoperatively) | 1.37 (1.01–1.85) | 0.0409 * |
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Behling, F.; Fodi, C.; Gepfner-Tuma, I.; Machetanz, K.; Renovanz, M.; Skardelly, M.; Bornemann, A.; Honegger, J.; Tabatabai, G.; Tatagiba, M.; et al. CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence. Cancers 2020, 12, 3620. https://doi.org/10.3390/cancers12123620
Behling F, Fodi C, Gepfner-Tuma I, Machetanz K, Renovanz M, Skardelly M, Bornemann A, Honegger J, Tabatabai G, Tatagiba M, et al. CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence. Cancers. 2020; 12(12):3620. https://doi.org/10.3390/cancers12123620
Chicago/Turabian StyleBehling, Felix, Christina Fodi, Irina Gepfner-Tuma, Kathrin Machetanz, Mirjam Renovanz, Marco Skardelly, Antje Bornemann, Jürgen Honegger, Ghazaleh Tabatabai, Marcos Tatagiba, and et al. 2020. "CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence" Cancers 12, no. 12: 3620. https://doi.org/10.3390/cancers12123620