Evaluation of the Prognostic Factors Effective on Local Recurrence in Atypical Meningiomas

INTRODUCTION: Meningiomas are the most common brain tumors and account for 13%–26% of intracranial tumors. Approximately, 5%–7% of the meningiomas are termed as atypical meningiomas. The prognosis in patients with benign meningioma (Grade I) is generally very favorable. The outcome for patients with atypical meningioma is progression that is rapid and more invasive.
METHODS: We retrospectively analyzed 35 patients with atypical meningiomas who underwent surgery. Patients’ age at diagnosis, gender, tumor location, Simpson grade, local tumor recurrence, and treatment with radiation therapy were evaluated.
RESULTS: Patients were aged 29–54 (mean±standard deviation: 54.6±12.1) years; 18 were females and 17 males. The recurrence rate was 6/35 (17.1%). Recurrence was found two times more in females. The parasagittal location of the tumor was most common in 66.6% cases. One-half of the patients did not receive adjuvant radiotherapy (RT). Patients characterized with Simpson Grade I showed lower recurrence rate compared to Grade III.
DISCUSSION AND CONCLUSION: Atypical meningioma recurs more frequently than Grade I lesions. The current management of atypical meningioma is maximal safe resection of tumor followed by adjuvant RT. Adjuvant RT following surgical resection is recommended particularly for incompletely excised tumors or tumors located in the parasagittal area or posterior fossa. In our study, the resection grade was identified as one of the most important factors affecting the prognosis.

Atipik Menenjiomlarda Lokal Rekürrens Üzerine Etkili Prognostik Faktörlerin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Tüm intrakranial beyin tümörlerinin %13-26’ sýný oluþturan menenjiomlar en yaygýn görülen beyin tümörleridir. Menenjiomlarýn yaklaþýk %5-7’si atipik menenjiomlardýr. Benign menenjiomlu hastalarýn (grade 1) prognozu genellikle oldukça iyi olup, atipik menemjiomlu (grade 2) hastalarda hýzlý progresyon ve daha fazla invazyon vardýr.
YÖNTEM ve GEREÇLER: Opere edilen 35 atipik menenjiomlu hasta retrospektif olarak incelendi. Hastalar yaþ, cinsiyet, tümör lokalizasyonu, Simpson grade, lokal tümör rekürrensi ve radyoterapi almasýna göre deðerlendirildi
BULGULAR: Hastalarýn yaþý 29 ile 54 arasýnda olup (ortalama 54.6±12.1), kadýn/erkek oraný 18/17 idi.. Rekürrens oranýnýn %17.1 (6/35) ve kadýnlarda iki kat fazla olduðu tespit edildi. Olgularýn %66.6’sýnda tümör parasagital lokalizasyonda idi. Hastalarýn yarýsýnýn adjuvan radyoterapi aldýðý görüldü. Simpson grade 1 olgularda tümör rekürrensinin istatiksel olarak daha az olduðunu tespit edildi.
TARTIÞMA ve SONUÇ: Atipik menenjiomlar grade 1 lezyonlardan daha sýk rekürrens gösterirler. Atipik menenjiomlarýn güncel tedavi yönetimi maksimal güvenli tümör rezeksiyonu sonrasý adjuvan radyoterapi uygulanmasýdýr. Özellikle total cerrahi yapýlamayan, parasagittal ve posterior fossa yerleþimli tümörü olan hastalarda adjuvan radyoterapi önerilmektedir. Yapýlan çalýþmada rekürrens üzerine etkin tek faktör olarak.tümör rezeksiyon derecesi tespit edilmiþtir.