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Maiuri F, Corvino S, Corazzelli G, Del Basso De Caro M. Single versus multiple reoperations for recurrent intracranial meningiomas. J Neurooncol 2024:10.1007/s11060-024-04673-8. [PMID: 38656725 DOI: 10.1007/s11060-024-04673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To identify the risk factors and management of the multiple recurrences and reoperations for intracranial meningiomas. METHODS Data of a neurosurgical series of 35 patients reoperated on for recurrent intracranial meningiomas were reviewed. Analyzed factors include patient age and sex, tumor location, extent of resection, WHO grade, Ki67-MIB1 and PR expression at initial diagnosis, time to recurrence; pattern of regrowth, extent of resection, WHO grade and Ki67-MIB1 at first recurrence were also analyzed. All these factors were stratified into two groups based on single (Group A) and multiple reoperations (Group B). RESULTS Twenty-four patients (69%) belonged to group A and 11 (31%) to group B. The age < 65 years, male sex, incomplete resection at both initial surgery and first reoperation, and multicentric-diffuse pattern of regrowth at first recurrence are risk factors for multiple recurrences and reoperations. In group B, the WHO grade and Ki67-MIB1 increased in further recurrences in 54% and 64%, respectively. The time to recurrence was short in 7 cases (64%), whereas 4 patients (36%) further recurred after many years. Eight patients (73%) are still alive after 7 to 22 years and 2 to 4 reoperations. CONCLUSION The extent of resection and the multicentric-diffuse pattern of regrowth at first recurrence are the main risk factors for multiple recurrences and reoperations. Repeated reoperations might be considered even in patients with extensive recurrent tumors before the anaplastic transformation occurs. In such cases, even partial tumor resections followed by radiation therapy may allow long survival in good clinical conditions.
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Affiliation(s)
- Francesco Maiuri
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, 80131, Naples, Italy
| | - Sergio Corvino
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, 80131, Naples, Italy.
| | - Giuseppe Corazzelli
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, 80131, Naples, Italy
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, Section of Pathology, University "Federico II" of Naples, 80131, Naples, Italy
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Cao D, Ou Y, Chen X, Guo Z, Chen Y, Chen J. Clinical outcomes after microsurgical resection of giant lateral ventricular meningiomas. Neurosurg Rev 2023; 46:33. [PMID: 36607461 DOI: 10.1007/s10143-022-01932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023]
Abstract
Giant lateral ventricular meningiomas (LVMs), with the largest diameter of at least 5 cm, form a distinct subset. The incidence of giant LVMs is considered to be relatively low. Here, we evaluated clinical characteristics, and clinical outcomes after microsurgical resection, especially functional outcomes and morbidity of giant LVMs. We retrospectively reviewed 49 patients with LVMs, including 18 giant LVMs from 2012 to 2020. And we analyzed clinical, histopathological, surgical, and outcome data at our institution. Giant LVMs were most commonly present in the fourth decade of patients with the male-to-female ratio of 1:2. The most common subtypes were transitional and fibrous. Most lesions were resected via the temporal or parieto-occipital approach in our series. The median volume of blood loss was higher in the giant group (900 vs. 600 ml, p = 0.02). Meanwhile, the median length of hospital stay was prolonged for giant LVMs (20.5 vs. 16.0 days, p < 0.01). The proportion of discharged functional deterioration was higher in giant LVMs (38.9% vs. 6.5%, p = 0.02). However, there was no statistical significance between functional deterioration and tumor size at long-term follow-up (p = 0.28). Giant LVMs patients suffered from neurological and regional complications more commonly, particularly from a postoperative hematoma (4/18 vs. 1/31), and hydrocephalus (2/18 vs. 0/31). Patients with giant LVMs had a high incidence of immediate functional deterioration after microsurgery, and there was no difference in functional deterioration between the giant and non-giant LVMS during long-term follow-up. Microsurgery entails a higher complication rate in giant LVMs. We need to pay special attention to preventing postoperative hematoma and hydrocephalus.
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Affiliation(s)
- Dan Cao
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yibo Ou
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xu Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhengqian Guo
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yong Chen
- Department of Neurosurgery Intensive Care Unit, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jian Chen
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Garrido Ruiz PA, González-Tablas M, Pasco Peña A, Zelaya Huerta MV, Ortiz J, Otero Á, Corchete LA, Ludeña MD, Caballero Martínez MC, Córdoba Iturriagagoitia A, Fernández IC, González-Carreró Fojón J, Hernández Laín A, Orfao A, Tabernero MD. Clinical, Histopathologic and Genetic Features of Rhabdoid Meningiomas. Int J Mol Sci 2023; 24:ijms24021116. [PMID: 36674634 PMCID: PMC9865044 DOI: 10.3390/ijms24021116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Rhabdoid meningiomas (RM) shows heterogeneous histological findings, and a wide variety of chromosomal copy number alterations (CNA) are associated with an unpredictable course of the disease. In this study, we analyzed a series of 305 RM samples from patients previously reported in the literature and 33 samples from 23 patients studied in our laboratory. Monosomy 22-involving the minimal but most common recurrent region loss of the 22q11.23 chromosomal region was the most observed chromosomal alteration, followed by losses of chromosomes 14, 1, 6, and 19, polysomies of chromosomes 17, 1q, and 20, and gains of 13q14.2, 10p13, and 21q21.2 chromosomal regions. Based on their CNA profile, RM could be classified into two genetic subgroups with distinct clinicopathologic features characterized by the presence of (1) chromosomal losses only and (2) combined losses and gains of several chromosomes. The latter displays a higher frequency of WHO grade 3 tumors and poorer clinical outcomes.
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Affiliation(s)
- Patricia Alejandra Garrido Ruiz
- Neurosurgery Service of the University Hospital of Salamanca, Surgery Department, University of Salamancaca (USAL), Paseo de la Transición Española, 37007 Salamanca, Spain
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - María González-Tablas
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
| | - Alejandro Pasco Peña
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | - María Victoria Zelaya Huerta
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | - Javier Ortiz
- Pathology Service of the University Hospital of Salamanca, Cell Biology and Pathology Department, Paseo de la Transición Española, 37007 Salamanca, Spain
| | - Álvaro Otero
- Neurosurgery Service of the University Hospital of Salamanca, Surgery Department, University of Salamancaca (USAL), Paseo de la Transición Española, 37007 Salamanca, Spain
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - Luis Antonio Corchete
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
| | - María Dolores Ludeña
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Pathology Service of the University Hospital of Salamanca, Cell Biology and Pathology Department, Paseo de la Transición Española, 37007 Salamanca, Spain
| | | | - Alicia Córdoba Iturriagagoitia
- Pathology Service of the University Hospital of Pamplona, Universidad Pública de Navarra, C. de Irunlarrea, 3, 31008 Navarra, Spain
| | | | | | - Aurelio Hernández Laín
- Pathology Service of the University Hospital 12 Octubre, Universidad Complutense, Av. de Córdoba, s/n, 28041 Madrid, Spain
| | - Alberto Orfao
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
| | - María Dolores Tabernero
- Institute for Biomedical Research of Salamanca, IBSAL University Hospital of Salamanca, Paseo de San Vicente, 58-182, 10ªPlanta, 37007 Salamanca, Spain
- Centre for Cancer Research (CIC-IBMCC; CSIC/USAL; IBSAL) and Department of Medicine, Campus Miguel de Unamuno, University of Salamanca, 37007 Salamanca, Spain
- Biomedical Research Networking Centre on Cancer—CIBERONC (CB16/12/00400), Institute of Health Carlos III, C. Sinesio Delgado, 4, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-923-29-48-11; Fax: +34-923-29-46-24
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Kwon SM, Kim JH, Kim YH, Hong SH, Cho YH, Kim CJ, Nam SJ. Clinical Implications of the Mitotic Index as a Predictive Factor for Malignant Transformation of Atypical Meningiomas. J Korean Neurosurg Soc 2021; 65:297-306. [PMID: 34879641 PMCID: PMC8918253 DOI: 10.3340/jkns.2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/23/2021] [Indexed: 11/27/2022] Open
Abstract
Objective Intracranial atypical meningiomas have a poor prognosis and high rates of recurrence. Moreover, up to one-third of the recurrences undergo high-grade transformation into malignant meningiomas. We aimed to investigate the clinical factors that can predict the propensity of malignant transformation from atypical to anaplastic meningiomas. Methods Between 2001 and 2018, all patients with atypical meningioma, in whom the tumors had undergone malignant transformation to anaplastic meningioma, were included. The patients' medical records documenting the diagnosis of atypical meningioma prior to malignant transformation were reviewed to identify the predictors of transformation. The control group comprised 56 patients with atypical meningiomas who were first diagnosed between January 2017 and December 2018 and had no malignant transformation. Results Nine patients in whom the atypical meningiomas underwent malignant transformation were included. The median time interval from diagnosis of atypical meningioma to malignant transformation was 19 months (range, 7-78). The study group showed a significant difference in heterogeneous enhancement (77.8% vs. 33.9%), bone invasion (55.6% vs. 12.5%), mitotic index (MI; 14.8±4.9 vs. 3.5±3.9), and Ki-67 index (20.7±13.9 vs. 9.5±7.1) compared with the control group. In multivariate analysis, increased MI (odds ratio, 1.436; 95% confidence interval, 1.127-1.900; p=0.004) was the only significant factor for predicting malignant transformation. Conclusion An increased MI within atypical meningiomas might be used as a predictor of malignant transformation. Tumors at high risk for malignant transformation might require more attentive surveillance and management than other atypical meningiomas.
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Affiliation(s)
- Sae Min Kwon
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Hoon Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Hoon Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok Ho Hong
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Jin Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo Jeong Nam
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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