Surgical Treatment of Meningiomas - Outcome Associated With Type of Resection, Recurrence, Karnofsky Performance Score, Mitotic Count

Robert Sumkovski; Micun Micunovic; Ivica Kocevski; Boro Ilievski; Igor Petrov

doi:10.3889/oamjms.2019.032

Authors

Robert Sumkovski University Clinic of Neurosurgery, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Micun Micunovic Special Hospital for Orthopedic Surgery and Traumatology â€œSt. Erazmoâ€, Ohrid, Republic of Macedonia
Ivica Kocevski University Clinic of Neurosurgery, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Boro Ilievski Institute of Pathological Anatomy, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Igor Petrov University Clinic of Neurology, Clinical Center Mother Theresa, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2019.032

Keywords:

Outcome of surgically treated meningiomas, Simpson, Karnofsky, Mitotic count

Abstract

BACKGROUND: Meningiomas are the type of central nervous system tumours, derived from the cells of the arachnoid membrane that are well constrained from surrounding tissues, mainly no infiltrating neoplasm with benign features. Meningiomas consist about 15-20% of all primary intracranial neoplasms.

AIM: The evaluation of the outcome of the operatively treated meningiomas in relation with the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion

METHODS: In this article 40 operatively treated patients are reviewed for the outcome of the operation about the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion.

RESULTS: Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been established.

CONCLUSION: Gender, age and Karnofsky performance score have predictive value in the treatment of different types of meningiomas. The magnitude of surgical resection is associated with the regrowth of a tumour. The mitotic count in different types of meningiomas presents significant feature in the appearance of meningioma recurrence. The surgical resection and the quality and quantity of patientâ€™s survival have a significant relation to the mitotic count of the meningiomas. There is no connection between the size and the localisation of a tumour related to different values of the mitotic count.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Thomas HG, Dolman CL, Berry K. Malingnant Meningioma: Clinical and Pathological Features. J Neurosurg. 1981; 55:929-34. https://doi.org/10.3171/jns.1981.55.6.0929 PMid:7299467 DOI: https://doi.org/10.3171/jns.1981.55.6.0929

Shehy JP, Crockard HA. Multiple Meningiomas: A long-Term Review. J Neurosurg. 1983; 59:1-5. https://doi.org/10.3171/jns.1983.59.1.0001 PMid:6864264 DOI: https://doi.org/10.3171/jns.1983.59.1.0001

Youmans J R, (ed.) Neurological Surgery. 3rd ed. W. B. Saunders, Philadelphia, 1990.

Louis DN, Scheithauer BW, Budka H, et al. Meningiomas. In: Kleihues P, Cavenee WK, eds. Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press; 2000; 176-184.

Zimmerman RD, Fleming CA, Saint-Louis LA, et al. Magnetic Resonance of Meningiomas. AJNR. 1985; 6:149-57. PMid:3920874

Vranic A, Popovic M, Cor A, Prestor B, Pizem J. Mitotic count, brain invasion and location are independent predictors of recurrence-free survival in primary atypical and malignant meningiomas: a study of 86 patients. Neurosurgery. 2010; 67:1124-1132. https://doi.org/10.1227/NEU.0b013e3181eb95b7 PMid:20881577 DOI: https://doi.org/10.1227/NEU.0b013e3181eb95b7

Zulch KJ. Histological typing of tumours of the central nervous system. International histological classification of tumours No 21. 1979:19-24.

Louis DN, Ohgaki H, Wiestler OD, editors. WHO classification of tumours of the central nervous system. WHO Regional Office Europe, 2007. DOI: https://doi.org/10.1007/s00401-007-0243-4

Stafford SL, Perry A, Suman VJ, Meyer FB, Scheithauer BW, Lohse CM, Shaw EG. Primarily resected meningiomas: outcome and prognostic factors in 581 Mayo Clinic patients, 1978 through 1988. Mayo Clinic Proceedings. 1998; 73(10:936-942. DOI: https://doi.org/10.4065/73.10.936

Yamashita J, Handa H, Iwaki K, et al. Recurence of Intracranial Meningiomas with Special Reference to Radiotherapy. Surg Neurol. 1980; 14:33-40. PMid:7414483

Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW. Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J Neurol Neurosurg Psychiatry. 2008; 79(5)574-580. https://doi.org/10.1136/jnnp.2007.121582 PMid:17766430 DOI: https://doi.org/10.1136/jnnp.2007.121582

Simpson D. The recurrence of intracranial meningiomas after surgical treatment. Journal of neurology, neurosurgery, and psychiatry. 1957; 20(1):22. https://doi.org/10.1136/jnnp.20.1.22 DOI: https://doi.org/10.1136/jnnp.20.1.22

Albright L, Riegel D H. Management of Hydrocephalus Secundary to Posterior Fossa Tumors. Preliminary Report. J Neurosurgery. 1977; 46:52-5. https://doi.org/10.3171/jns.1977.46.1.0052 PMid:830815 DOI: https://doi.org/10.3171/jns.1977.46.1.0052

Kleihues P, Burger P C, Scheithauer B W. The new WHO Classification of Brain Tumors. Brain Pathol. 1993; 3:255-68. https://doi.org/10.1111/j.1750-3639.1993.tb00752.x PMid:8293185 DOI: https://doi.org/10.1111/j.1750-3639.1993.tb00752.x

Ho D, Hsu C, Ting L, et al. Histopathology and MIB-1 labeling index predicted recurrence of meningiomas: a proposal of diagnostic criteria for patients with atypical meningiomas. Cancer. 2002; 94:1538-1547. https://doi.org/10.1002/cncr.10351 PMid:11920512 DOI: https://doi.org/10.1002/cncr.10351

Maier H, Wanschitz J, Sedivy R, et al. Proliferation and DNA fragmentation in meningioma subtypes. Neuropathol ApplNeurobiol. 1997; 23:496-506. https://doi.org/10.1111/j.1365-2990.1997.tb01327.x DOI: https://doi.org/10.1046/j.1365-2990.1997.00071.x

Kim YJ, Ketter R, Steudel WI, Feiden W. Prognostic significance of the mitotic index using the mitosis marker antiâ€“phosphohistone H3 in meningiomas. American journal of clinical pathology. 2007; 128(1):118-25. https://doi.org/10.1309/HXUNAG34B3CEFDU8 PMid:17580279 DOI: https://doi.org/10.1309/HXUNAG34B3CEFDU8

Perry A, Stafford SL, Scheithauer BW, et al. Meningioma grading: an analysis of histological parameters. Am J Surgical Pathology. 1997; 21:1455-1466. https://doi.org/10.1097/00000478-199712000-00008 DOI: https://doi.org/10.1097/00000478-199712000-00008

Perry A, Stafford SL, Scheithauer BW, et al. The prognostic significance of MIB-1, p53, and DNA flow cytometry in completely resected primary meningiomas. Cancer. 1998; 82:2262-2269. https://doi.org/10.1002/(SICI)1097-0142(19980601)82:11<2262::AID-CNCR23>3.0.CO;2-R DOI: https://doi.org/10.1002/(SICI)1097-0142(19980601)82:11<2262::AID-CNCR23>3.0.CO;2-R

Mahmood A, Caccamo D V, Tomecek F J, et al. Atypical and Malignant Meningiomas: A Clinico-pathological Review. Neurosurgery. 1993; 33:955-63. https://doi.org/10.1227/00006123-199312000-00001 DOI: https://doi.org/10.1227/00006123-199312000-00001

Kim YJ, Romeike BFM, Uszkoreit J, et al. Automated nuclear segmentation in the determination of the Ki-67 labeling-index in meningiomas. Clin Neuropathology. 2006; 25:67-73. PMid:16550739

Kolles H, Niedermayer I, Schmitt C, et al. Triple approach for diagnosis and grading of meningiomas: histology, morphometry of Ki-67/Feulgen stainings, and cytogenetics. Acta Neurochir (Wien). 1995; 137:174-181. https://doi.org/10.1007/BF02187190 DOI: https://doi.org/10.1007/BF02187190

Abramovich CM, Prayson RA. Histopathologic features and MIB-1 labeling indices in recurrent and nonrecurrent meningiomas. Arch Pathol Lab Med. 1999; 123:793-800. PMid:10458826 DOI: https://doi.org/10.5858/1999-123-0793-HFAMLI

Modha A, Gutin PH. Diagnosis and treatment of atypical and malignant meningiomas: a review. Neurosurgery. 2005; 57(3):538-550. https://doi.org/10.1227/01.NEU.0000170980.47582.A5 PMid:16145534 DOI: https://doi.org/10.1227/01.NEU.0000170980.47582.A5

Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC. "Malignancy" in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer. 1999; 85(9):2046-2056. PMid:10223247 DOI: https://doi.org/10.1002/(SICI)1097-0142(19990501)85:9%3C2046::AID-CNCR23%3E3.0.CO;2-M

Kallio M, Sankila R, Hakulinen T, Jaaskelainen J. Factors affecting operative and excess long-term mortality in 935 patients with intracranial meningiomas. Neurosurgery. 1992; 31(2):2-12. PMid:1641106 DOI: https://doi.org/10.1227/00006123-199207000-00002

Kleihues P, Burger PC, Scheithauer BW. Histologic typing of tumors of the Central Nervous System. Berlin. Germany. Springer-Verlag, 1993. https://doi.org/10.1007/978-3-642-84988-6 DOI: https://doi.org/10.1007/978-3-642-84988-6

Kleihues P, Cavenee WK, eds. Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press, 2000; 176-184.

Palma L, Celli P, Franco C, Cervoni L, Cantore G. Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases. J Neurosurg. 1997; 86(5):793-800. https://doi.org/10.3171/jns.1997.86.5.0793 PMid:9126894 DOI: https://doi.org/10.3171/jns.1997.86.5.0793

Pasquier D, Bijmolt S, Veninga T, et al. Atypical and malignant meningioma: outcome and prognostic factors in 119 irradiated patients. A multicenter, retrospective study of the Rare Cancer Network. Int J Radit Oncol Biol Phys. 2008; 71(5):1388-1393. https://doi.org/10.1016/j.ijrobp.2007.12.020 PMid:18294779 DOI: https://doi.org/10.1016/j.ijrobp.2007.12.020

Adegbite AV, Khan MI, Paine KWE, et al. The Recurrence of Intracranial Meningiomas After Surgical Treatment. J Neurosurg. 1983; 58:51-6. https://doi.org/10.3171/jns.1983.58.1.0051 PMid:6847909 DOI: https://doi.org/10.3171/jns.1983.58.1.0051

Mirimanoff RO, Dosoretz DE, Lingood RM, et al. Meningioma: Analysis of Recurence and Progression Following Neurosurgical Resection. J Neurosurg. 1985; 62:18-24. https://doi.org/10.3171/jns.1985.62.1.0018 PMid:3964853 DOI: https://doi.org/10.3171/jns.1985.62.1.0018

Colman H, Giannini C, Huang L, et al. Assessment and prognostic significance of mitotic index using the mitosis marker phospho-histone H3 in low and intermediate â€“grade infiltrating astrocytomas. American Jornal of Surgical Pathology. 2006; 30:657-664. https://doi.org/10.1097/01.pas.0000202048.28203.25 PMid:16699322 DOI: https://doi.org/10.1097/01.pas.0000202048.28203.25

Akagami R, Napolitano M, Sekhar LN. Patient-evaluated outcome after surgery for basal meningiomas. Neurosurgery. 2002; 50(5):941-9. PMid:11950396 DOI: https://doi.org/10.1227/00006123-200205000-00005