Acta Neurochirurgica

, Volume 161, Issue 12, pp 2563–2570 | Cite as

Risk factors associated with postoperative recurrence in atypical intracranial meningioma: analysis of 263 cases at a single neurosurgical centre

  • Fang Wang
  • Dingkang Xu
  • Yumeilan Liu
  • Yazhou Lin
  • Qingjie Wei
  • Qiang Gao
  • Shixiong Lei
  • Fuyou GuoEmail author
Original Article - Tumor - Meningioma
Part of the following topical collections:
  1. Tumor – Meningioma



Atypical meningioma (AM) has a high rate of local recurrence after surgery, and the role of adjuvant radiotherapy in AM remains controversial. We analysed progression-free survival (PFS) and identified the factors associated with postoperative recurrence in AM patients.


Data were obtained from 263 AM patients who underwent surgery at our institution between October 2009 and September 2018. Analyses included factors such as the extent of surgical resection, MIB-1 labelling index, brain invasion and therapy modality. Univariate and multivariate analyses were used to assess recurrence-related prognostic factors.


The median follow-up duration was 41 months, and the median PFS was 28 months. Gross total resection (GTR) was achieved in 213 (81.0%) patients, and 86 (32.7%) patients received postoperative radiation therapy (RT). During follow-up, there were 61 (23.2%) tumour recurrences. In a Cox multivariate analysis, MIB-1 labelling index (hazard ratio = 2.637; p < 0.001), secondary tumour (hazard ratio = 3.541; p < 0.001), tumour size (hazard ratio = 1.818; p = 0.032) and extent of resection (hazard ratio = 2.861; p < 0.001) were independent significant predictors of tumour recurrence. RT was associated with reduced tumour recurrence in subtotal resection (STR) (p = 0.023) but not GTR (p = 0.923). An analysis of 6 meningioma patients who underwent more than 3 operations suggested that the recurrence time became shorter and the MIB-1 labelling index increased as the number of recurrences increased.


MIB-1 labelling index, secondary tumour, tumour size and extent of resection were powerful predictors of recurrence in AM patients. Postoperative RT did not decrease the risk of recurrence in GTR patients.


Atypical meningioma Progression-free survival Recurrence Adjuvant radiotherapy Prognostic factors 



Thanks for the language editing service from American Journal Experts.

Funding information

This work was supported by grants from the Science and Technology Department of Henan province (192102310113) and the Educational Department of Henan province (19B320017).

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  2. 2.Department of PathologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  3. 3.Key Laboratory of Neurosurgical DiseasesThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

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