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. 2023 Apr 11:3:101740.
doi: 10.1016/j.bas.2023.101740. eCollection 2023.

Differences in intraoperative sampling during meningioma surgery regarding CNS invasion - Results of a survey on behalf of the EANS skull base section

Felix Behling  1   2   3 , Michaël Bruneau  4 , Jürgen Honegger  1   3 , Moncef Berhouma  5 , Emmanuel Jouanneau  6 , Luigi Cavallo  7 , Jan Frederick Cornelius  8 , Mahmoud Messerer  9 , Roy Thomas Daniel  9 , Sébastien Froelich  10 , Diego Mazzatenta  11 , Torstein Meling  12 , Dimitrios Paraskevopoulos  13 , Pierre-Hugues Roche  14 , Henry W S Schroeder  15 , Idoya Zazpe  16 , Eduard Voormolen  17 , Massimiliano Visocchi  18 , Ekkehard Kasper  19 , Jens Schittenhelm  3   20 , Marcos Tatagiba  1   3
Affiliations

Differences in intraoperative sampling during meningioma surgery regarding CNS invasion - Results of a survey on behalf of the EANS skull base section

Felix Behling et al. Brain Spine. .

Abstract

Introduction: and Research Question: Invasive growth of meningiomas into CNS tissue is rare but of prognostic significance. While it has entered the WHO classification as a stand-alone criterion for atypia, its true prognostic impact remains controversial. Retrospective analyses, on which the current evidence is based, show conflicting results. Discordant findings might be explained by different intraoperative sampling methodologies.

Material and methods: To assess the applied sampling methods in the light of the novel prognostic impact of CNS invasion, an anonymous survey was designed and distributed via the EANS website and newsletter. The survey was open from June 5th until July 15th, 2022.

Results: After exclusion of 13 incomplete responses, 142 (91.6%) datasets were used for statistical analysis. Only 47.2% of participants' institutions utilize a standardized sampling method, and 54.9% pursue a complete sampling of the area of contact between the meningioma surface and CNS tissue. Most respondents (77.5%) did not change their sampling practice after introduction of the new grading criteria to the WHO classification of 2016. Intraoperative suspicion of CNS invasion changes the sampling for half of the participants (49.3%). Additional sampling of suspicious areas of interest is reported in 53.5%. Dural attachment and adjacent bone are more readily sampled separately if tumor invasion is suspected (72.5% and 74.6%, respectively), compared to meningioma tissue with signs of CNS invasion (59.9%).

Discussion and conclusions: Intraoperative sampling methods during meningioma resection vary among neurosurgical departments. There is need for a structured sampling to optimize the diagnostic yield of CNS invasion.

Keywords: Brain invasion; CNS invasion; EANS; Intraoperative sampling; Meningioma; Survey.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Bar graph showing the responses to questions regarding the participants' institution (A), position (B) and exposure to meningioma surgery (C and D).
Fig. 2
Fig. 2
Bar graph depicting the answers to questions focusing on characteristics of current sampling methodologies.
Fig. 3
Fig. 3
Bar graphs showing the perception of the value of intraoperative findings and preoperative MR-imaging characteristics regarding CNS invasive growth (A and B) and participants' responses regarding intraoperative proceedings in the case of suspicious invasive growth (C, D, E and F).
Fig. 4
Fig. 4
Bar graphs presenting the scientific activity of participants regarding meningioma research and methodology of scientific tissue sampling during meningioma resection.
See this image and copyright information in PMC

References

    1. Adeli A., Hess K., Mawrin C., Streckert E.M.S., Stummer W., Paulus W., Kemmling A., Holling M., Heindel W., Schmidt R., Spille D.C., Sporns P.B., Brokinkel B. Prediction of brain invasion in patients with meningiomas using preoperative magnetic resonance imaging. Oncotarget. 2018;9(89):35974–35982. - PMC - PubMed
    1. Banan R., Abbetmeier-Basse M., Hong B., Dumitru C.A., Sahm F., Nakamura M., Krauss J.K., Hartmann C. Neuropathol Appl Neurobiol; 2021. The Prognostic Significance of Clinicopathological Features in Meningiomas: Microscopic Brain Invasion Can Predict Patient Outcome in Otherwise Benign Meningiomas. - PubMed
    1. Baumgarten P., Gessler F., Schittenhelm J., Skardelly M., Tews D.S., Senft C., Dunst M., Imoehl L., Plate K.H., Wagner M., Steinbach J.P., Seifert V., Mittelbronn M., Harter P.N. Brain invasion in otherwise benign meningiomas does not predict tumor recurrence. Acta Neuropathol. 2016;132(3):479–481. - PubMed
    1. Behling F., Fodi C., Gepfner-Tuma I., Kaltenbach K., Renovanz M., Paulsen F., Skardelly M., Honegger J., Tatagiba M., International Consortium on M., Schittenhelm J., Tabatabai G. Neuro Oncol; 2020. H3K27me3 Loss Indicates an Increased Risk of Recurrence in the Tubingen Meningioma Cohort. - PMC - PubMed
    1. Behling F., Fodi C., Gepfner-Tuma I., Machetanz K., Renovanz M., Skardelly M., Bornemann A., Honegger J., Tabatabai G., Tatagiba M., Schittenhelm J. CNS invasion in meningioma-how the intraoperative assessment can improve the prognostic evaluation of tumor recurrence. Cancers. 2020;12(12) - PMC - PubMed

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