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
. 2021 Jun;153(2):313-320.
doi: 10.1007/s11060-021-03771-1. Epub 2021 May 10.

Clinical characteristics and management differences for grade II and III spinal meningiomas

William E Krauss  1 , Yagiz Ugur Yolcu  1   2 , Mohammed Ali Alvi  1   2 , F M Moinuddin  1   2 , Anshit Goyal  1   2 , Michelle J Clarke  1 , W Richard Marsh  1 , Mohamad Bydon  3   4
Affiliations

Clinical characteristics and management differences for grade II and III spinal meningiomas

William E Krauss et al. J Neurooncol. 2021 Jun.

Abstract

Purpose: The majority of spinal meningiomas are grade I tumors, as defined by World Health Organization (WHO) classification making atypical (grade II) or anaplastic (grade III) tumors extremely rare lesions to encounter in clinical practice. Here, we present our institutional experience of management of grade II and III spinal meningiomas.

Methods: Following IRB approval, we queried all available institutional electronic medical records for patients undergoing surgical resection of pathology-proven spinal meningiomas, with further review of patients with grade II and III. Variables of interest included age, sex, histological type, tumor size, symptoms at baseline, treatment characteristics, symptom resolution at the last follow-up, recurrence, NF-2 status, concurrent intracranial meningioma, and mortality. Kaplan Meier curves were constructed to study time to progression/recurrence.

Results: A total of 188 patients undergoing surgical resection of spinal meningioma between 1988 and 2018 were identified. Among those, 172 (91.5%) patients had grade I meningioma and 16 (8.5%) patients had high grade meningiomas [grade II (15) and III (1)]. Over a median (IQR) follow-up of 8.0 years (5.1-13.0), mortality and recurrence rates were 18.8% (n = 3) and 47.1% (n = 8), respectively. In univariate analysis, adjuvant radiotherapy and thoracic segment involvement were associated with lower rates of recurrence while male sex was associated with a higher rate of recurrence.

Conclusions: Results showed variations in clinical outcomes for patients with high grade spinal meningiomas, especially the recurrence. Adjuvant radiotherapy and thoracic segment involvement was associated with lower rates of recurrence while recurrence ocurred at a higher rate in males.

Keywords: Meningioma; Radiotherapy; Recurrence; Simpson; Surgery; WHO grade.

PubMed Disclaimer

References

    1. Solero CL, Fornari M, Giombini S et al (1989) Spinal meningiomas: review of 174 operated cases. Neurosurgery 25(2):153–160 - DOI
    1. Ames CP, Boriani S, Jandial R (2013) Spine and spinal cord tumors: advanced management and operative techniques. Taylor & Francis Group LLC, New York
    1. Koeller KK, Shih RY (2019) Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. Radiographics 39(2):468–490 - DOI
    1. Riemenschneider MJ, Perry A, Reifenberger G (2006) Histological classification and molecular genetics of meningiomas. Lancet Neurol 5(12):1045–1054 - DOI
    1. Sandalcioglu IE, Erol Sandalcioglu I, Hunold A et al (2008) Spinal meningiomas: critical review of 131 surgically treated patients. Eur Spine J 17(8):1035–1041. https://doi.org/10.1007/s00586-008-0685-y - DOI - PubMed - PMC

LinkOut - more resources