Early Postoperative Adjuvant Radiotherapy Versus Active Monitoring After Gross Total Resection for Atypical Meningiomas: Factors Associated with Early Recurrence


GÜRSES M. E., ZENGİN H. Y., Shikhaliyeva A., AŞKUN C. S., Mut M.

Turkish Neurosurgery, vol.33, no.4, pp.635-641, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.5137/1019-5149.jtn.41369-22.1
  • Journal Name: Turkish Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Page Numbers: pp.635-641
  • Keywords: Atypical, Meningioma, Radiotherapy, Recurrence, Resection
  • Middle East Technical University Affiliated: Yes

Abstract

AIM: To investigate the predictors of recurrence after gross total resection (GTR) that require early adjuvant radiotherapy upfront rather than at initial recurrence of atypical meningiomas (AMs). MATERIAL and METHODS: A retrospective study of gross totally resected AMs was conducted in a tertiary care center within ten years. The clinical, radiological, and pathological parameters were analyzed statistically, and the factors associated with recurrence after GTR were determined with univariate analysis. RESULTS: Among 23 AMs with GTR, 34.8% showed recurrence in a median follow-up of 40 months after the surgery. Preoperative tumor volume, tumor location in the skull base or tentorium, and lack of progesterone expression were associated with the higher recurrence rate. AMs with a preoperative volume of 27.5 cm3 were the most significant risk factor for the recurrence (a 9.3-fold increase) than those with <27.5 cm3 (66.7% vs. 14.3%, respectively). CONCLUSION: Patients diagnosed with larger AMs (> 27.5 cm3) might have higher recurrence rates after GTR and, therefore, would benefit from early adjuvant radiotherapy without waiting for a recurrence. AMs located in the skull base or tentorium and AMs having no progesterone expression might also be potential predictors for recurrence.