Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan;126(1):107-116.
doi: 10.1007/s11060-015-1940-9. Epub 2015 Sep 26.

Predictors of recurrence in the management of chordoid meningioma

Winward Choy  1 , Leonel Ampie  1 , Jonathan B Lamano  1 , Kartik Kesavabhotla  1 , Qinwen Mao  2 , Andrew T Parsa  1 , Orin Bloch  3
Affiliations

Predictors of recurrence in the management of chordoid meningioma

Winward Choy et al. J Neurooncol. 2016 Jan.

Erratum in

Abstract

Management of chordoid meningiomas (CMs) is complicated by high rates of recurrence, particularly following subtotal resection. Optimal management is not established given the paucity of published experience. To identify prognostic factors for recurrence following resection, the authors conducted the largest systematic review of CMs to date. A comprehensive search on MEDLINE (OVID and Pubmed), Scopus, Embase, and Web of Science utilizing the search terms "chordoid" AND "meningioma" was performed to identify all reports of pathologically confirmed intracranial CMs. A total of 221 patients were included, comprising 120 females and 101 males. Mean age, MIB-1/Ki67, and tumor size was 45.5 years, 4.3% (range 0.1-26.6%), and 4.1 cm (range 0.8-10 cm), respectively. 5-, and 10- year progression free survival was 67.5 and 54.4%, respectively. Gross total resection (GTR) and subtotal resection was achieved in 172 and 48 patients, respectively. Adjuvant radiotherapy (RT) was given to 30 patients. Multivariate analysis found GTR was strongly correlated with decreased recurrence rates (HR 0.04, p = <0.0001), while higher MIB-1 labeling index (≥5 vs <5%) was associated with increased recurrence (HR 7.08; p = 0.016). Adjuvant RT, age, gender, and tumor location were not associated with recurrence. GTR resection is the strongest predictor of tumor control, and should be the goal to minimize local progression. Additionally, higher MIB-1 labeling was associated with increased rates of tumor recurrence. Tumors that are subtotally resected or demonstrate higher MIB-1 are at greater recurrence and warrant consideration for RT and close long term follow up.

Keywords: Atypical; Chordoid; Meningioma; Radiation therapy; Surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
Figure 2
Figure 2
Kaplan Meier curve for all patients included within the study. 3- and 5- year PFS was 76.0% and 67.5%, respectively.
Figure 3
Figure 3
Kaplan Meier analysis of recurrence free survival following either gross (GTR) to subtotal (STR) resection. Greater extent of surgery was associated with improved rates of tumor control. For GTR, 3- and 5- year PFS was 85.3% and 80.8%, respectively. For STR, 3- and 5- year PFS was 50.7 and 33.8%, respectively, p <0.001.
Figure 4
Figure 4
Kaplan Meier analysis of recurrence free survival for patients who have undergone surgery only without adjuvant radiotherapy. Greater extent of surgery was associated with improved rates of tumor control. For GTR only, 3- and 5- year PFS was 86.4% and 83.5%, respectively. For STR only, 3- and 5- year PFS was 53.3% and 29.6%, respectively, p <0.001.
Figure 5
Figure 5
Kaplan Meier analysis of recurrence free survival based on MIB Labeling index (<5% vs ≥5%). Higher MIB-LI was associated with poorer rates of tumor control. Within the low MIB-LI group, 3- and 5- year PFS was 83.3% and 71.5%. Within the high MIB-LI group, 3- and 5- year PFS was 68.0% and 68.0%, respectively p= 0.03.
See this image and copyright information in PMC

References

    1. Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK. The WHO classification of tumors of the nervous system. Journal of neuropathology and experimental neurology. 2002;61:215–225. discussion 226-219. - PubMed
    1. Couce ME, Aker FV, Scheithauer BW. Chordoid meningioma: a clinicopathologic study of 42 cases. The American journal of surgical pathology. 2000;24:899–905. - PubMed
    1. Epari S, Sharma MC, Sarkar C, Garg A, Gupta A, Mehta VS. Chordoid meningioma, an uncommon variant of meningioma: a clinicopathologic study of 12 cases. Journal of neuro-oncology. 2006;78:263–269. doi:10.1007/s11060-005-9092-y. - PubMed
    1. Kepes JJ, Chen WY, Connors MH, Vogel FS. “Chordoid” meningeal tumors in young individuals with peritumoral lymphoplasmacellular infiltrates causing systemic manifestations of the Castleman syndrome. A report of seven cases. Cancer. 1988;62:391–406. - PubMed
    1. Kozler P, Benes V, Netuka D, Kramar F, Hrabal P, Charvat F. Chordoid meningioma: presentation of two case reports, review of the literature, and plea for data standardisation. Journal of neuro-oncology. 2008;88:115–120. doi:10.1007/s11060-008-9541-5. - PubMed

Publication types