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Prior surgery, lesion location may be linked to higher-grade meningiomas
Kane AJ. Cancer. 2011;117:1272-1278.
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Patients presenting with nonskull base lesions were at double the risk for grade 2 or 3 tumors as patients with skull base lesions, according to study results.
Researchers from one US site aimed to evaluate risk factors for higher-grade tumors in a cohort of 378 patients presenting with histologically confirmed meningioma, central pathology grading according to WHO guidelines, and tumor location confirmed with preoperative imaging.
Univariate analysis results indicated that nonskull base lesions were more likely than skull base lesions to be associated with grade 2 or 3 tumors, 27% vs. 12% (P>.001). Multivariate analysis results indicated that nonskull base lesions carried twice the risk for grade 2 or 3 tumors as skull base lesions (OR=2.13; 95% CI, 1.2-3.8).
Men were at greater risk for grade 2 or 3 tumors compared with women, 30% vs. 14% (P>.001), despite constituting 30% of the study population. Men had a twofold risk for higher grade tumors compared with women, according to multivariate analysis results (OR=2.10; 95% CI, 1.2-3.8).
Surgery for interval growth or atypical features revealed in an MRI was performed in less than 3% of patients. However, more than 97% of patients in the cohort underwent surgery for a tumor larger than 3 cm or for clinically debilitating symptoms.
Patients who had previously undergone tumor excision were more likely to develop higher-grade tumors, according to univariate analysis (50% vs. 16%; P>.001). Prior surgery remained linked to higher-grade tumor development in a multivariate analysis (OR=3.5; 95% CI, 1.5-8).
Prior radiation therapy, the presence of a preoperative deficit and age older than 65 years were significantly associated with higher-grade tumors in univariate but not multivariate analyses.
The study was conducted because grade 2 and 3 meningiomas are more likely to result in recurrence than grade 1 meningiomas after surgery and/or external irradiation, according to the researchers, who said earlier assessment of the nature of the tumor is necessary as noninvasive treatments become more useful.
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