Angiogenesis and expression of estrogen and progesterone receptors as predictive factors of recurrence in meningiomas: A long-term prospective study

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e13013 Background: Meningioma is a bening tumor, with a high rate of recurrence after surgery (80%); the most important relapse predictive factor is the extent of surgical resection; other potentially predictive factors have been studied with poor results. Angiogenesis has an important role in growth and spread of neoplasic cells; previous studies have shown a high incidence of cyclin E (CE), estrogen, and progesterone receptors (ER, PR) in meningiomas. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), vascular density index (VDI), cell proliferation index (CPI), CE, ER, and PR tissue expression in meningioma recurrence of patients submitted to surgical resection. Methods: From January 1995 to December 2000, we enrolled 42 patients with histopathological diagnosis of meningioma and treated only with surgical resection. Tumor VDI, CPI, CE, ER, and PR tissue expression were evaluated by immunohistochemistry in patients with or without recurrence. CPF, VDI, CPI, and expression of CE, ER, and PR were associated with recurrence. Results: Complete surgical resection was achieved in 32.5% of patients. Minimal follow-up was 6 years. Recurrence of meningioma was found in 17 patients (40%). Mean time of recurrence was 32 + 8 months. Tissue expression was positive for CE, ER, and PR in 90.9%, 27.6%, and in 64% of patients, respectively. VDI was >8 (40X in 10 fields) in 52.6% of patients and CPI was >600 (40X in 10 fields) in 54.2% of patients. Significant recurrence-associated factors were extent of resection (RR = 2.4, 95% CI 1.7–2.9, p = 0.03) and VDI >8 (RR = 1.7, 95% CI 1.003–2.9, p = 0.001). CPI, CE, ER, and PR expressions were not statistically significant (p = 0.83, p = 0.16, p = 0.46, and p = 0.74, respectively). Conclusions: Patients with partially resected meningioma and high VDI have an increased recurrence risk and could benefit of additional therapeutic measures. No significant financial relationships to disclose.