Treatment and prognostic analysis of intracranial anaplastic meningioma

Abstract

Objective To investigate the treatment and prognosis of intracranial anaplastic meningioma. Methods From January 2008 to July of 2013, the clinical data of 51 patients with intracranial anaplastic meningioma received surgical treatment at the Cooperative Wards, Departments of Neurosurgery, Beijing Electrical Power Hospital and Beijing Tiantan Hospital, Capital Medical University were analyzed retrospectively. Their factors related to prognosis were analyzed. Results All 51 patients received surgical treatment. The tumors were confirmed as anaplastic (malignant) meningioma by histopathology. Forty-six of them were followed up, 24 had Simpson grade I resection in the first operation, and a total of 22 had Simpson grade Ⅱ and Ⅲ resection. The postoperative complications were mainly the loss of nerve function on the location of the tumors. In the 46 patients to be followed up, a total of 96 surgeries were performed, 37 had recurrence. The recurrence rate was 80%, and 2-year recurrence rate was 52%. The progression-free survival (PFS) was 2-73 (median 24) months. In the 46 patients to be followed up, 12 patients were in a Simpson grade I resection combined radiotherapy group, 12 were in a Simpson grade I resection without radiotherapy group, 11 were in a Simpson Grade Ⅱ and Ⅲ resection without radiotherapy group. The median PFS in each group were 72, 20, 24, and 13 months, respectively (P=0.001). The recurrence rates were 58%, 92%, 91%, and 91%, respectively. Conclusions Anaplastic meningioma is a malignant tumor with high recurrence rate and high mortality. The degrees of surgical resection and postoperative radiotherapy have obvious influence on the prognosis of the tumors. The tumors with Simpson grade I resection and postoperative radiotherapy may significantly prolong PFS, but the decrease of tumor recurrence rate is not obvious. Simpson grade I resection of the tumor should be achieved as far as possible and postoperative radiotherapy is an effective treatment means for anaplastic meningioma. Key words: Meningioma; Microsurgery; Radiotherapy; Prognosis