Prognostic role of extent of resection and adjuvant radiotherapy in de novo anaplastic meningiomas

Pauline Marijon^{1

2}, Martin Planet¹, Suzanne Tran³, Julien Boetto^{2

4}, Oumaima Aboubakr¹, Ronan Legrand⁵, Jérôme-Alexandre Denis^{5

6}, Anne-Sophie Montero⁷, Stéphane Goutagny⁸, Johan Pallud^{9

10}, Dominique Cazals-Hatem¹¹, Pascale Varlet^{10

12}, Michel Kalamarides^{1

2}, Matthieu Peyre^{13

14}

Affiliations

¹ Sorbonne Universités - Department of Neurosurgery, Bâtiment Babinski, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
² Genetics and Development of Brain Tumors - CRICM INSERM U1127 CNRS UMR 7225 - Brain Institute, Hôpital de La Pitié-Salpêtrière, Paris, France.
³ Department of Neuropathology, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France.
⁴ Neurosurgery Department, Gui de Chauliac Hospital, Montpellier University Medical Center, 91 Avenue Augustin Fliche, 34090, Montpellier, France.
⁵ Department of Endocrine Biochemistry and Oncology, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
⁶ Saint-Antoine Research Center, ISERM U938, Biology and Oncology Therapeutics, IUC, Sorbonne University, Paris, France.
⁷ Department of Neurosurgery, Henri Mondor Hospital, APHP, 1 Rue Gustave Eiffel, 94000, Créteil, France.
⁸ Department of Neurosurgery, Beaujon Hospital, APHP, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
⁹ Department of Neurosurgery, Sainte-Anne Hospital, APHP, 1 Rue Cabanis, 75014, Paris, France.
¹⁰ Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, INSERM U1266, 75014, Paris, France.
¹¹ Department of Neuropathologie, Beaujon Hospital, APHP, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
¹² Department of Neuropathology, Sainte-Anne Hospital, APHP, 1 Rue Cabanis, 75014, Paris, France.
¹³ Sorbonne Universités - Department of Neurosurgery, Bâtiment Babinski, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France. matthieu.peyre@aphp.fr.
¹⁴ Genetics and Development of Brain Tumors - CRICM INSERM U1127 CNRS UMR 7225 - Brain Institute, Hôpital de La Pitié-Salpêtrière, Paris, France. matthieu.peyre@aphp.fr.

PMID: 39607523
DOI: 10.1007/s00701-024-06336-z

Multicenter Study

Prognostic role of extent of resection and adjuvant radiotherapy in de novo anaplastic meningiomas

Pauline Marijon et al. Acta Neurochir (Wien). 2024.

. 2024 Nov 28;166(1):486.

doi: 10.1007/s00701-024-06336-z.

Authors

Affiliations

¹ Sorbonne Universités - Department of Neurosurgery, Bâtiment Babinski, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
² Genetics and Development of Brain Tumors - CRICM INSERM U1127 CNRS UMR 7225 - Brain Institute, Hôpital de La Pitié-Salpêtrière, Paris, France.
³ Department of Neuropathology, Sorbonne University, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France.
⁴ Neurosurgery Department, Gui de Chauliac Hospital, Montpellier University Medical Center, 91 Avenue Augustin Fliche, 34090, Montpellier, France.
⁵ Department of Endocrine Biochemistry and Oncology, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
⁶ Saint-Antoine Research Center, ISERM U938, Biology and Oncology Therapeutics, IUC, Sorbonne University, Paris, France.
⁷ Department of Neurosurgery, Henri Mondor Hospital, APHP, 1 Rue Gustave Eiffel, 94000, Créteil, France.
⁸ Department of Neurosurgery, Beaujon Hospital, APHP, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
⁹ Department of Neurosurgery, Sainte-Anne Hospital, APHP, 1 Rue Cabanis, 75014, Paris, France.
¹⁰ Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, INSERM U1266, 75014, Paris, France.
¹¹ Department of Neuropathologie, Beaujon Hospital, APHP, 100 Boulevard du Général Leclerc, 92110, Clichy, France.
¹² Department of Neuropathology, Sainte-Anne Hospital, APHP, 1 Rue Cabanis, 75014, Paris, France.
¹³ Sorbonne Universités - Department of Neurosurgery, Bâtiment Babinski, Groupe Hospitalier Pitié-Salpêtrière, APHP, 47-83 Boulevard de L'Hôpital, 75013, Paris, France. matthieu.peyre@aphp.fr.
¹⁴ Genetics and Development of Brain Tumors - CRICM INSERM U1127 CNRS UMR 7225 - Brain Institute, Hôpital de La Pitié-Salpêtrière, Paris, France. matthieu.peyre@aphp.fr.

PMID: 39607523
DOI: 10.1007/s00701-024-06336-z

Abstract

Purpose: Grade 3 meningiomas, although rare, are associated with high morbidity and mortality. The respective impacts of extent of surgical resection and adjuvant radiotherapy are still debated. Moreover, anaplastic meningiomas are studied in heterogenous cohort of de novo and progressive anaplastic tumors.

Methods: We conducted a retrospective multicentric study on patients operated from a de novo anaplastic meningioma between 1999 and 2021. A centralized pathological review using 2016 WHO criteria was performed for all cases. Patients with history of radiotherapy or NF2-related Schwannomatosis were excluded.

Results: Sixty-five patients were included in the study. Median progression free survival was 23 months and median overall survival was 2 years. Neither quality of resection nor adjuvant radiotherapy alone were predictive of better overall survival. Progression free survival were impacted by combination of gross-total resection and adjuvant radiotherapy (HR = 0.47 CI95% = [0.24-0.92], p = 0.027) and age at diagnosis (HR = 2.92 CI95% = [1.38-6.21], p = 0.005) in univariate analyses. Within anaplastic tumors, those graded on mitosis number had a poorer prognosis than those graded on overt anaplasia. Among anaplastic tumors with high mitotic score (> 20/10HPF), progression free survival were impacted by postoperative radiotherapy (HR = 0.44 CI95% = [0.22-0.88], p = 0.020) and gross total resection and adjuvant radiotherapy association (HR = 0.44 CI95% = [0.21-0.90], p = 0.024) in univariate analyses.

Conclusion: Simpson grade didn't show any impact on overall survival. Gross total resection + adjuvant radiotherapy favorably impacted progression free survival in our cohort of de novo anaplastic meningiomas.

Keywords: Adjuvant radiotherapy; Malignant meningioma; Meningioma; Upfront radiotherapy; WHO grade 3.

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Conflict of interest statement

Declarations. Ethical approval: Not applicable. Competing interests: The authors declare no competing interests.

References

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Prognostic role of extent of resection and adjuvant radiotherapy in de novo anaplastic meningiomas

Affiliations

Prognostic role of extent of resection and adjuvant radiotherapy in de novo anaplastic meningiomas

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Miscellaneous