MS-15 * THE IMPACT OF HISTOPATHOLOGIC AND RADIOLOGIC CHARACTERISTICS IN CLINICAL OUTCOME OF PATIENTS WHO UNDERWENT SURGERY FOR INTRACRANIAL MENINGIOMAS

Abstract

INTRODUCTION: Meningiomas are common intracranial neoplasms with variability in their clinical presentation, biological behavior and response to treatment. PURPOSE: The aim of this study was to identify factors that predict the biological behaviour of meningiomas and patients' postsurgical outcome. METHODOLOGY: We retrospectively reviewed 415 meningiomas cases who had undergone surgical resection at Toronto Western Hospital between January 2007 to June 2013. Our cohort consisted of 162 males and 253 females. We reviewed clinical, radiological, and pathological reports, and collected the following data for statistical analysis: patients' sex, age, tumor grade-location, presence of peritumoral edema prior to surgical resection, tumors' largest diameter as a clinical measure of tumor size and history of radiation. All analyses were performed using IBM SPSS 20.0. RESULTS: The incidence of peritumoral edema was significantly higher in males (75%) than in females patients (52%) (p = 0.007). Meningioma location was associated with presence of edema (p < 0.001): olfactory meningiomas showed the highest incidence of edema (71.4%) followed by convexity meningiomas (62%), and sphenoid wing meningiomas (72%) (p < 0.001). Tumors with larger diameters (4.3cm vs. 3.5cm) were likely to have peritumoral edema (p = 0.001). The history of radiation was significantly correlated with peritumoral brain edema (76.4%, p = 0.003). The presence of residual tumor after surgical resection was more likely in meningiomas with higher grades; residual tumor was most common in grade III meningioma (75%) followed by grade II (29.3%), and grade I (17.7%) (p = 0.008). In radiation induced meningiomas the incidence of residual was 41.1%. Also, the grade of tumor was significantly correlated with the incidence of recurrence; grade III meningiomas showed the highest incidence of recurrence (50%) followed by grade II (19.5%) and grade I (4.1%) (p < 0.001). CONCLUSION: The present study demonstrates that specific demographic, radiologic, and pathologic characteristics are significant predictors of tumor response to therapy, tumor recurrence and overall patient outcome.