Multicentric and diffuse recurrences of meningiomas
| Autor: | Oreste de Divitiis, C. Peca, Elia Guadagno, Francesco Maiuri, Stefania d'Avanzo, Giuseppe Mariniello, Marialaura Del Basso De Caro, Sergio Corvino |
|---|---|
| Přispěvatelé: | Maiuri, F., Mariniello, G., Peca, C., Guadagno, E., Corvino, S., D'Avanzo, S., Del Basso De Caro, M., de Divitiis, O. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
recurrence Proliferation index Meningioma Brain Neoplasm 03 medical and health sciences 0302 clinical medicine Retrospective Studie Meningeal Neoplasms medicine proliferation index Humans Meningeal Neoplasm Pathological Retrospective Studies Brain Neoplasms business.industry General Medicine medicine.disease 030220 oncology & carcinogenesis Surgery Neurology (clinical) Radiology Neoplasm Recurrence Local business 030217 neurology & neurosurgery Human |
| Popis: | Background: Meningiomas recur with a rate of 10–32% at 10 years. Several features influence the risk of recurrence. Objective: To define the pathological and surgical features at risk of multicentric-diffuse versus local–peripheral recurrence. Methods: Thirty-three patients operated on for intracranial meningiomas who experienced multicentric-diffuse recurrence were retrospectively analyzed. The data of these patients were compared to those of 50 patients who experienced local–peripheral recurrence. The analyzed factors included age and sex, tumor location and shape, brain-tumor interface, entity of resection, WHO grade, Ki67 MIB1, progesterone receptor (PR) expression, number of reoperations, progression of WHO grade, and outcome. Results: Meningiomas which recurred in multicentric-diffuse pattern showed at initial surgery a significantly higher rate of flat-shaped tumors (p =.0008) and of cases with Ki67 Li ≥ 4% (p =.037) than those which recurred in localized-peripheral pattern, whereas other factors did not significantly differ. Among patients with multicentric-diffuse recurrences, 25 underwent one to three reoperations; 17 among them (66%) are alive with local tumor control or slow progression 2–25 years after the initial surgery versus only 2 out of 8 who did not undergo surgery. Conclusions: Flat-shaped meningiomas and those with Ki67 Li ≥ 4% are at higher risk of multicentric-diffuse recurrence. Multiple reoperations over a period of several years may obtain rather long survivals in selected patients with prevalent intradural, not anaplastic tumors and not too extensive dural infiltration. |
| Databáze: | OpenAIRE |
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