Meningiomas in patients with long-term exposition to progestins: Characteristics and outcome

Autor: Frederic Castinetti, Thomas Cuny, Sébastien Boissonneau, Mohamed Boucekine, Dominique Figarella-Branger, Stéphane Fuentes, Thierry Brue, Thomas Graillon, Kaissar Farah, Romain Appay, Hadrien Peyrière, Frédérique Albarel, Isabelle Morange, Henry Dufour, Mikael Meyer
Přispěvatelé: Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Anatomie Pathologique-Neuropathologique [AP-HM Hôpital La Timone], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)
Rok vydání: 2021
Předmět:
Nomegestrol acetate
medicine.medical_specialty
Proliferation index
medicine.drug_class
[SDV]Life Sciences [q-bio]
education
Population
Urology
Acétate de nomegestrol
Progesterone receptor
Meningioma
03 medical and health sciences
Chlormadinone acetate
chemistry.chemical_compound
0302 clinical medicine
Acétate de chlormadinone
otorhinolaryngologic diseases
Meningeal Neoplasms
medicine
Humans
Cyproterone Acetate
neoplasms
Skull Base
education.field_of_study
business.industry
Acétate de cyprotérone
Cyproterone acetate
Méningiome
medicine.disease
nervous system diseases
3. Good health
Discontinuation
Progestin
chemistry
030220 oncology & carcinogenesis
Progestatif
Surgery
Neurology (clinical)
Progestins
business
hormones
hormone substitutes
and hormone antagonists
Récepteur à la progesterone
030217 neurology & neurosurgery
Zdroj: Neurochirurgie
Neurochirurgie, 2021, ⟨10.1016/j.neuchi.2021.04.018⟩
Neurochirurgie, Elsevier Masson, 2021, ⟨10.1016/j.neuchi.2021.04.018⟩
ISSN: 0028-3770
1773-0619
DOI: 10.1016/j.neuchi.2021.04.018
Popis: Objective The aim of this study was to describe progestin-associated meningiomas’ characteristics, outcome and management. Material and methods We included 53 patients operated on and/or followed in the department for meningioma with progestin intake longer than one year and with recent drug discontinuation. Results Cyproterone acetate (CPA), nomegestrol acetate (NomA), and chlormadinone acetate (ChlA) were involved in most cases. Mean duration of progestin drugs intake was 17.5 years. Tumors were multiple in 66% of cases and were located in the anterior and the medial skull base in 71% of cases. Transitional subtype represented 16/25 tumors; 19 meningiomas were WHO grade I and 6 were grade II. The rate of transitional subtype and skull base location was significantly higher compared to matched operated meningioma general population. No difference was observed given WHO classification. But Ki67 proliferation index tends to be lower and 5/6 of the WHO grade II meningiomas were classified as WHO grade II because of brain invasion. Strong progesterone receptors expression was observed in most cases. After progestin discontinuation, a spontaneous visual recovery was observed in 6/10 patients. Under CPA (n = 24) and ChlA/NomA (n = 11), tumor volume decreased in 71% and 18% of patients, was stabilized in 25% and 64% of patients, and increased in 4% and 18% of patients, respectively. Volume outcome was related to meningioma location. Conclusions Outcome at progestins discontinuation is favorable but different comparing CPA versus ChlA-NomA and comparing tumor location. Long-term follow-up is required. In most cases, simple observation is recommended and surgery should be avoided.
Databáze: OpenAIRE
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