Clinical and histopathological predictors of outcome in malignant meningioma

AbstractWe investigated possible clinical and histopathological prognostic factors in a malignant meningioma cohort with comprehensive long-term population-based follow-up data. Twenty-four consecutive patients treated surgically for malignant meningioma at the Department of Neurosurgery and the Department of Pathology, Rigshospitalet, Copenhagen, Denmark, from December 2000 to March 2014 were retrospectively evaluated regarding progression-free survival (PFS) and overall survival (OS). Clinical parameters were recorded. All specimens underwent immunohistochemical analysis for Ki-67 and phosphohistone-H3 (PHH3). Prognostication was assessed with Cox proportional hazard regression analysis. The median follow-up was 46.1  months (range 0.7–150.7). The median progression-free survival was 16.5 months (95% CI 11.4–43.0) and the median overall survival was 46.6 months (95% CI 20.4–NA). Six patients were alive at the end of follow-up; two of these had not experienced a recurrence. No clinical parameter showed s ignificant association with PFS or OS. Mitotic index (MI) was significantly associated with PFS and OS, and PHH3 MI with PFS. Immunohistochemical reactivity of Ki-67 >  10% was a negative predictor of PFS (HR 3.92, 95% CI 1.47–10.4,p = 0.0063) and OS (HR 3.35, 95% CI 1.12–10.1,p = 0.0313). The histological subgrouping of grade III meningioma into anaplastic and non-anaplastic revealed increased PFS for the latter (HR 4.57, CI 95% 1.32–15.7,p =...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research