Survival Rates and Prognostic Predictors of Anaplastic Meningiomas.

Abstract

BACKGROUND\nAnaplastic meningiomas are rare tumors with a poor prognosis, even after complete surgical resection and radiotherapy. Thus far, there has been limited evidence with respect to the clinical factors and their effects on the course of the disease. Unfortunately, various retrospective studies have not been able to provide clear evidence of standardized treatment, usually presenting contradictory results. The aim of this study was to evaluate the prognostic factors influencing the progression-free survival (PFS) and overall survival (OS) rates of anaplastic meningiomas, with a particular focus on the roles of the extent of resection and postoperative adjuvant radiotherapy.\n\n\nMETHODS AND RESULTS\nBetween October 2001 and March 2016, 36 patients with anaplastic meningiomas were treated in our Department of Neurosurgery, of whom 11 patients underwent gross total resection (GTR) and 18 patients subtotal resection (STR). Twenty-one patients received postoperative adjuvant radiotherapy, and eight were treated with surgery alone. GTR (Simpson grades I and II) was associated with significantly improved PFS (p-value = 0.01) and OS (p-value = 0.004). Furthermore, adjuvant radiotherapy demonstrated an improvement in PFS (p-value = 0.01) but not in OS (p-value = 0.16).\n\n\nCONCLUSION\nThe extent of resection in anaplastic meningiomas is correlated with a better outcome. However, resection alone is not sufficient for the long-term control of anaplastic meningiomas. Adjuvant radiotherapy is an essential component in the adjuvant treatment of anaplastic meningiomas, including for patients undergoing GTR. Further investigations through which to improve adjuvant therapy options are necessary in order to improve meningioma therapy.