ABSTRACT
Objective To explore the correlation of molecular pathological grading with WHO grade 1 meningioma recurrence, malignant progression, and patients’ survival. Methods The medical records and paraffin-embedded tissues of patients with surgically resected WHO grade 1 meningioma were collected. The molecular pathological risk grading suggested by Maas et al. was adopted, and the patients were graded as low, intermediate, and high risk. Univariate log-rank test and multivariate Cox regression analyses were performed to determine the relationship between molecular risk grading and patient progression-free survival (PFS), malignant progression-free survival (MPFS), and overall survival (OS). Results Among 198 patients, 152 (76.8%) were graded as low risk, showing no 1p deletion; 42 (21.2%) patients were graded as intermediate risk, including 18 patients with 1p deletion, 10 patients with 1p combined with 6q deletion, and 14 patients with 1p combined with 14q deletion; and 4 (2%) patients were graded as high risk, including two patients with TERT promoter mutation, one patient with CDKN2A/B homozygous deletion, and one patient with 1p, 6p, and 14q combined deletion. Multivariate analysis showed that molecular risk grading was negatively associated with PFS (HR: 0.029, 95%CI: 0.011-0.080), MPFS (HR: 0.032, 95%CI: 0.004-0.274), and OS (HR: 0.074, 95%CI: 0.032-0.174; P<0.05). Conclusion The biological behavior of histological grade 1 meningiomas still exhibits heterogeneity, and further molecular pathological risk grading can more accurately reflect their biological behavior and evaluate patient prognosis.
ABSTRACT
Objective To summarize the clinical features of asymptomatic meningioma patients and evaluate the factors re-lated to surgical complications and prognosis,and to provide evidence for screening asymptomatic meningioma patients suitable for early surgical intervention.Methods The medical records of meningioma patients who underwent surgery from January 1st 2015 to December 31st 2020 at Neurosurgery Department of Tongji Hospital Affiliated to Tongji Medical College were retro-spectively reviewed.The clinical characteristics were compared between symptomatic and asymptomatic meningioma.Factors re-lated to the effects of surgery,postsurgical complications or patient prognosis were analyzed through Chi-squared test and multi-variate binary Logistic regression analysis.Results Elder age(HR:2.042;95％CI:1.002-4.098;P=0.021),smaller tumor size(HR:1.666;95％CI:1.009-3.857;P=0.014),intracranial superficial location(HR:2.221;95％CI:1.236-3.994;P=0.008)and no peritumoral brain edema(HR:8.917;95％CI:5.028-15.813;P＜0.01)were significant features of asymptomat-ic meningioma compared to those of symptomatic ones.The benefit of early surgery for asymptomatic meningioma was the a-chievement of higher total resection rate(88.6％)(P=0.035).Among the total resection cases,72％located in the intracranial superficial area,while merely 28％located in the intracranial deep area.Ninety-two percent of asymptomatic patients had re-turned to normal work and life at 6 months after operation.A parietal location was a significant factor indicating postsurgical complications(HR:3.351;95％CI:1.258-11.355;P=0.024),while elder age(≥60 years old)(HR:0.875;95％CI:0.825-0.999;P=0.041)was a significant factor indicating poor patient prognosis.Conclusion Asymptomatic meningioma is more common in elderly patients,usually located superficially in cranial cavity,with smaller size and without peritumoral edema.A more prominent total resection rate can be achieved in this type of meningioma.An early surgical resection would be recommen-ded as a proper treatment strategy.Tumor site and age are potential indicators for predicting postoperative complications and prognosis of patients.Comprehensive evaluation should be consider before surgery.