CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence
The detection of the infiltrative growth of meningiomas into CNS tissue has been integrated into the WHO classification as a stand-alone marker for atypical meningioma. However, its prognostic impact has been questioned. Infiltrative growth can also be detected intraoperatively. The prognostic impac...
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doaj-2bea542ad7e649fca6cb5ec0b26dc7eb2020-12-04T00:02:29ZengMDPI AGCancers2072-66942020-12-01123620362010.3390/cancers12123620CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor RecurrenceFelix Behling0Christina Fodi1Irina Gepfner-Tuma2Kathrin Machetanz3Mirjam Renovanz4Marco Skardelly5Antje Bornemann6Jürgen Honegger7Ghazaleh Tabatabai8Marcos Tatagiba9Jens Schittenhelm10Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyCenter for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyCenter for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyDepartment of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyCenter for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, GermanyThe detection of the infiltrative growth of meningiomas into CNS tissue has been integrated into the WHO classification as a stand-alone marker for atypical meningioma. However, its prognostic impact has been questioned. Infiltrative growth can also be detected intraoperatively. The prognostic impact of the intraoperative detection of the central nervous system tissue invasion of meningiomas was analyzed and compared to the histopathological assessment. The clinical data of 1517 cases with follow-up data regarding radiographic recurrence was collected. Histopathology and operative reports were reviewed and invasive growth was seen during resection in 23.7% (<i>n</i> = 345) while histopathology detected it in 4.8% (<i>n</i> = 73). The histopathological and intraoperative assessments were compatible in 63%. The prognostic impact of histopathological and intraoperative assessment was significant in the univariate but not in the multivariate analysis. Both methods of assessment combined reached statistical significance in the multivariate analysis (<i>p</i> = 0.0409). A score including all independent prognostic factors divided the cohort into three prognostic subgroups with a risk of recurrence of 33.8, 64.7 and 88.5%, respectively. The intraoperative detection of the infiltrative growth of primary meningiomas into the central nervous system tissue can complement the histopathological assessment of CNS invasion. The combined assessment is an independent prognostic factor regarding tumor recurrence and allows a risk-adapted tumor stratification.https://www.mdpi.com/2072-6694/12/12/3620meningiomabrain invasionCNS invasioninvasive growthintraoperative assessmentrecurrence risk |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Felix Behling Christina Fodi Irina Gepfner-Tuma Kathrin Machetanz Mirjam Renovanz Marco Skardelly Antje Bornemann Jürgen Honegger Ghazaleh Tabatabai Marcos Tatagiba Jens Schittenhelm |
spellingShingle |
Felix Behling Christina Fodi Irina Gepfner-Tuma Kathrin Machetanz Mirjam Renovanz Marco Skardelly Antje Bornemann Jürgen Honegger Ghazaleh Tabatabai Marcos Tatagiba Jens Schittenhelm CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence Cancers meningioma brain invasion CNS invasion invasive growth intraoperative assessment recurrence risk |
author_facet |
Felix Behling Christina Fodi Irina Gepfner-Tuma Kathrin Machetanz Mirjam Renovanz Marco Skardelly Antje Bornemann Jürgen Honegger Ghazaleh Tabatabai Marcos Tatagiba Jens Schittenhelm |
author_sort |
Felix Behling |
title |
CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence |
title_short |
CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence |
title_full |
CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence |
title_fullStr |
CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence |
title_full_unstemmed |
CNS Invasion in Meningioma—How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence |
title_sort |
cns invasion in meningioma—how the intraoperative assessment can improve the prognostic evaluation of tumor recurrence |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-12-01 |
description |
The detection of the infiltrative growth of meningiomas into CNS tissue has been integrated into the WHO classification as a stand-alone marker for atypical meningioma. However, its prognostic impact has been questioned. Infiltrative growth can also be detected intraoperatively. The prognostic impact of the intraoperative detection of the central nervous system tissue invasion of meningiomas was analyzed and compared to the histopathological assessment. The clinical data of 1517 cases with follow-up data regarding radiographic recurrence was collected. Histopathology and operative reports were reviewed and invasive growth was seen during resection in 23.7% (<i>n</i> = 345) while histopathology detected it in 4.8% (<i>n</i> = 73). The histopathological and intraoperative assessments were compatible in 63%. The prognostic impact of histopathological and intraoperative assessment was significant in the univariate but not in the multivariate analysis. Both methods of assessment combined reached statistical significance in the multivariate analysis (<i>p</i> = 0.0409). A score including all independent prognostic factors divided the cohort into three prognostic subgroups with a risk of recurrence of 33.8, 64.7 and 88.5%, respectively. The intraoperative detection of the infiltrative growth of primary meningiomas into the central nervous system tissue can complement the histopathological assessment of CNS invasion. The combined assessment is an independent prognostic factor regarding tumor recurrence and allows a risk-adapted tumor stratification. |
topic |
meningioma brain invasion CNS invasion invasive growth intraoperative assessment recurrence risk |
url |
https://www.mdpi.com/2072-6694/12/12/3620 |
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