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WHO grade I meningiomas: classification-tree for prognostic factors of survival

  • Jean-Michel LeméeEmail author
  • Holger Joswig
  • Michele Da Broi
  • Marco Vincenzo Corniola
  • David Scheie
  • Karl Schaller
  • Eirik Helseth
  • Torstein R. Meling
Original Article
  • 37 Downloads

Abstract

World Health Organization (WHO) grade I meningiomas are intracranial extracerebral tumors, in which microsurgery as a stand-alone therapy provides high rates of disease control and low recurrence rates. Our aim was to identify prognostic factors of overall survival and time-to-retreat (OS; TTR) in a cohort of patients with surgically managed WHO grade I meningioma. Patients with WHO grade I meningiomas from a retrospectively (1990 to 2002) and prospectively managed (2003 to 2010) databank of Oslo University Hospital, Norway, were included. The mean follow-up was 9.2 ± 5.7 years, with a total of 11,414 patient-years. One thousand three hundred fifty-five patients were included. The mean age was 58 ± 13.2, mean Karnofsky Performance Status (KPS) 92.6 ± 26.1 and female-to-male ratio 2.5:1. The 1-year, 5-year, 10-year, 15-year, and 20-year probabilities were 0.98, 0.91, 0.87, 0.84, and 0.8 for TTR. Patient age (OR 0.92 [0.91, 0.94]), male sex (OR 0.59 [0.45, 0.76]), preoperative KPS ≥ 70 (OR 2.22 [1.59, 3.13]), skull base location (OR 0.77 [0.60, 1]), and the occurrence of a postoperative hematoma (OR 0.44 [0.26, 0.76]) were identified as independent prognostic factors of OS. Patient age (OR 1.02 [1.01, 1.03]) and skull base location (OR 0.30 [0.21, 0.45]) were independent predictors of decreased PFS. Using a recursive partitioning analysis, we suggest a classification tree for the prediction of 5-year PFS based on patient and tumor characteristics. The findings from this cohort of meningioma WHO I patients helps to identify patients at risk of recurrence and tailor the therapeutic management.

Keywords

Meningioma Overall survival Prognostic factors Time-to-retreat WHO grade I 

Notes

Acknowledgments

The authors would like to thank Bernt Filip Hasseleid MD, Andreas Mathisen MD, Andreas Hessen Schei MD, and Kristina M. Ødegaard MD for their valuable contributions in collecting data for this manuscript and the neurosurgeons of Rikshospitalet and Ullevaal for their dedicated patient care.

Authors’ contribution

Data collection: TRM, EH, DS.

Statistical analysis: JML.

Manuscript drafting: JML, HJ, MDB, MVC, TRM.

Critical revision: all authors.

Manuscript approval: all authors.

Funding

The authors do not declare any source of funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was regulated by the Personal Data Act/Personal Health Data Filing System Act and approved by the Data Protection Official at OUH (2017/5204).

Informed consent

Informed consent was not required by the Personal Data Act/Personal Health Data Filing System Act.

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

Authors and Affiliations

  1. 1.Department of Clinical Neurosciences, Division of NeurosurgeryGeneva University HospitalsGenevaSwitzerland
  2. 2.Service de NeurochirurgieHôpitaux Universitaires de GenèveGenèveSwitzerland
  3. 3.Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.Section of NeuropathologyRigshospitaletCopenhagenDenmark
  5. 5.Faculty of MedicineUniversity of GenevaGenevaSwitzerland
  6. 6.Department of NeurosurgeryOslo University HospitalOsloNorway

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