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Atypical and malignant meningioma: outcome and prognostic factors in 119 irradiated patients. A multicenter, retrospective study of the Rare Cancer Network

Pasquier, David
Bijmolt, Stefan
Veninga, Theo
Rezvoy, Nicolas
Villa, Salvador
Krengli, Marco
Baumert, Brigitta G.
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Published in International Journal of Radiation Oncology, Biology, Physics. 2008, vol. 71, no. 5, p. 1388-1393
Abstract PURPOSE: To retrospectively analyze and assess the outcomes and prognostic factors in a large number of patients with atypical and malignant meningiomas. METHODS AND MATERIALS: Ten academic medical centers participating in this Rare Cancer Network contributed 119 cases of patients with atypical or malignant meningiomas treated with external beam radiotherapy (EBRT) after surgery or for recurrence. Eligibility criteria were histologically proven atypical or anaplastic (malignant) meningioma (World Health Organization Grade 2 and 3) treated with fractionated EBRT after initial resection or for recurrence, and age >18 years. Sex ratio (male/female) was 1.3, and mean (+/-SD) age was 57.6 +/- 12 years. Surgery was macroscopically complete (Simpson Grades 1-3) in 71% of patients; histology was atypical and malignant in 69% and 31%, respectively. Mean dose of EBRT was 54.6 +/- 5.1 Gy (range, 40-66 Gy). Median follow-up was 4.1 years. RESULTS: The 5- and 10-year actuarial overall survival rates were 65% and 51%, respectively, and were significantly influenced by age >60 years (p = 0.005), Karnofsky performance status (KPS) (p = 0.01), and high mitotic rate (p = 0.047) on univariate analysis. On multivariate analysis age >60 years (p = 0.001) and high mitotic rate (p = 0.02) remained significant adverse prognostic factors. The 5- and 10-year disease-free survival rates were 58% and 48%, respectively, and were significantly influenced by KPS (p = 0.04) and high mitotic rate (p = 0.003) on univariate analysis. On multivariate analysis only high mitotic rate (p = 0.003) remained a significant prognostic factor. CONCLUSIONS: In this multicenter retrospective study, age, KPS, and mitotic rate influenced outcome. Multicenter prospective studies are necessary to clarify the management and prognostic factors of such a rare disease.
Keywords Analysis of VarianceFemaleHumansMaleMeningeal Neoplasms/mortality/*radiotherapy/surgeryMeningioma/mortality/*radiotherapy/surgeryMiddle AgedNeoplasm Recurrence, Local/mortality/radiotherapyRetrospective StudiesSurvival RateTreatment Outcome
Stable URL https://archive-ouverte.unige.ch/unige:19117
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PMID: 18294779
Research group Groupe Weber Damien (oncologie pédiatrique) (894)

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Deposited on : 2012-03-27

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