Clinical Factors and Outcomes of Atypical Meningioma: A Population-Based Study.

Gui-Jun Zhang,Xiao-Yin Liu,Chao You

doi:10.3389/fonc.2021.676683

Gui-Jun Zhang, Xiao-Yin Liu + Show 1 more

Open Access

https://doi.org/10.3389/fonc.2021.676683

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Abstract

ObjectiveAtypical meningioma is a non-benign tumor, and its prognostic factors and treatment strategies are unclear.MethodsPatients with atypical meningioma, between 2004 and 2016, were collected from the Surveillance, Epidemiology, and End Results database. Then, we randomly divided patients into a training set and a validation set at a ratio of 8:2. The nomogram was constructed based on the multivariate Cox regression analyses. And the concordance index, calibration curves, and receiver operating character were used to assess the predictive ability of the nomogram. We divided the patient scores into three groups and constructed a survival curve using Kaplan–Meier analysis.ResultsAfter our inclusion and exclusion criteria, 2358 patients were histologically diagnosed of atypical meningioma. The prognostic nomogram comprised factors of overall survival, including age, tumor size and surgery. The concordance index was 0.715 (95%CI=0.688-0.742) for overall survival in the training set and 0.688 (95%CI=0.629-0.747) for overall survival in the validation set. The calibration curves and receiver operating character also indicated the good predictability of the nomogram. Risk stratification revealed a statistically significant difference among the three groups of patients according to quartiles of risk score.ConclusionGross total resection is an independent factor for survival, and radiation after non-gross total resection potentially confers a survival advantage for patients with atypical meningioma.

Highlights

Meningiomas constitute the most prevalent primary intracranial tumor, with an annual incidence of around 5 per 100,000 individuals, which account for approximately 30% of central nervous system, ranging from World Health Organization (WHO) grade I benign to WHO grade III malignant meningioma [1, 2]
Given the controversy in the literature, and undetailed enunciation about prognostic factors for atypical meningioma from small series [10,11,12], we aimed to identify the prognostic factors to modify treatment strategies so as to improve the survival of patients with this tumor
The age and tumor size were divided into subgroups using the receiver operating character (ROC)

Summary

Introduction

Meningiomas constitute the most prevalent primary intracranial tumor, with an annual incidence of around 5 per 100,000 individuals, which account for approximately 30% of central nervous system, ranging from World Health Organization (WHO) grade I benign to WHO grade III malignant meningioma [1, 2]. For treatment strategy in the atypical meningioma, an increasing number of reports advocated the critical importance of extensive resection as initial therapy [4, 5], which indicated the extent of Atypical Meningioma resection affected prognosis. On the other hand, limited literature existed over whether radiotherapy should be added into standard therapy regardless of the extent of resection for this non-benign tumor [6,7,8,9]. Given the controversy in the literature, and undetailed enunciation about prognostic factors for atypical meningioma from small series [10,11,12], we aimed to identify the prognostic factors to modify treatment strategies so as to improve the survival of patients with this tumor. A nomogram model was established and validated for reliable estimation of 3-, 5-, and 8-year survival

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Conclusion