scholarly journals Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma

Cancer ◽  
2017 ◽  
Vol 124 (4) ◽  
pp. 734-742 ◽  
Author(s):  
Nicholas R. Rydzewski ◽  
Maciej S. Lesniak ◽  
James P. Chandler ◽  
John A. Kalapurakal ◽  
Erqi Pollom ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Total Resection

scholarly journals Adjuvant radiotherapy versus observation following gross total resection for atypical meningioma: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Se-Woong Chun ◽  
Kyung Min Kim ◽  
Min-Sung Kim ◽  
Ho Kang ◽  
Yun-Sik Dho ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Recurrence Rate ◽  
Adjuvant Radiotherapy ◽  
Local Recurrence Rate ◽  
Meta Analysis ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Survival Outcomes ◽  
Total Resection ◽  
The Impact

Abstract Background The impact of adjuvant radiotherapy (RT) on atypical meningioma (AM) underwent a gross total resection (GTR) remains unclear, showing conflicting results from various studies. The objective of this study was to perform an updated meta-analysis for observational studies to determine the effect of adjuvant RT after GTR on local recurrence and survival outcomes compared to observation after GTR. Methods PubMed, Embase, and Web of Science were searched to identify comparative studies that reported outcomes of adjuvant RT versus observation for AM patients after GTR. Local recurrence rate, progression-free survival (PFS), overall survival (OS), and toxicities related to RT were considered as outcomes of interest. Differences between two cohorts were estimated by calculating odds ratios (OR) for LR rate and hazard ratios (HR) for survival outcomes with 95% confidence intervals (CIs) for meta-analysis, using R version 4.0.3 software. Included studies were appraised with the Risk of Bias Assessment tool for Non-Randomized Studies. Outcome ratios were combined with the Mantel–Haenszel method and the inverse variance-weighted method, appropriately. Results Data from 30 studies involving 2904 patients (adjuvant RT: n = 737; observation: n = 2167) were eventually included. Significant reduction of local recurrence rate was seen in the adjuvant RT cohort compare to that in the observation cohort (OR 0.50; 95% CI 0.36–0.68; p < 0.0001). Pooled HRs of PFS at 1-year, 3-year, 5-year, and > 5-year revealed that adjuvant RT was superior to observation. There was no significant difference in OS between the two cohorts during any period. Most toxicities were tolerable with grade 1 or 2. There was no documented grade 5 toxicity. Conclusions For AM patients who underwent GTR, evidence suggested that adjuvant RT could potentially decrease local recurrence and improve PFS better than observation.

scholarly journals Determining the role of adjuvant radiotherapy in the management of meningioma: a Surveillance, Epidemiology, and End Results analysis

2019 ◽  
Vol 46 (6) ◽  
pp. E3 ◽  
Author(s):  
Abhinav K. Reddy ◽  
James S. Ryoo ◽  
Steven Denyer ◽  
Laura S. McGuire ◽  
Ankit I. Mehta
Keyword(s):  
Adjuvant Radiotherapy ◽  
Survival Benefit ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
Cause Specific Survival ◽  
End Results

OBJECTIVEThe aim of this study was to illustrate the demographic characteristics of meningioma patients and observe the effect of adjuvant radiation therapy on survival by using the Surveillance, Epidemiology, and End Results (SEER) database. More specifically, the authors aimed to answer the question of whether adjuvant radiotherapy following resection of atypical meningioma confers a cause-specific survival benefit. Additionally, they attempted to add to previous characterizations of the epidemiology of primary meningiomas and assess the effectiveness of the standard of care for benign and anaplastic meningiomas. They also sought to characterize the efficacy of various treatment options in atypical and anaplastic meningiomas separately since nearly all other analyses have grouped these two together despite varying treatment regimens for these behavior categories.METHODSSEER data from 1973 to 2015 were queried using appropriate ICD-O-3 codes for benign, atypical, and anaplastic meningiomas. Patient demographics, tumor characteristics, and treatment choices were analyzed. The effects of treatment were examined using a multivariate Cox proportional hazards model and Kaplan-Meier survival analysis.RESULTSA total of 57,998 patients were included in the analysis of demographic, meningioma, and treatment characteristics. Among this population, cases of unspecified WHO tumor grade were excluded in the multivariate analysis, leaving a total of 12,931 patients to examine outcomes among treatment paradigms. In benign meningiomas, gross-total resection (HR 0.289, p = 0.013) imparted a significant cause-specific survival benefit over no treatment. In anaplastic meningioma cases, adjuvant radiotherapy imparted a significant survival benefit following both subtotal (HR 0.089, p = 0.018) and gross-total (HR 0.162, p = 0.002) resection as compared to gross-total resection alone. In atypical tumors, gross-total resection plus radiotherapy did not significantly change the hazard risk (HR 1.353, p = 0.628) compared to gross-total resection alone. Similarly, it was found that adjuvant radiation did not significantly benefit survival after a subtotal resection (HR 1.440, p = 0.644).CONCLUSIONSThe results of this study demonstrate that the role of adjuvant radiotherapy, especially after the resection of atypical meningioma, remains somewhat unclear. Thus, given these results, prospective randomized clinical studies are warranted to provide clear information on the effects of adjuvant radiation in meningioma treatment.

scholarly journals Effectiveness of Postoperative Adjuvant Radiotherapy in Atypical Meningioma Patients After Gross Total Resection: A Meta-Analysis Study

2021 ◽  
Vol 10 ◽  
Author(s):  
Lingzhe He ◽  
Buyi Zhang ◽  
Jianmin Zhang ◽  
Zhige Guo ◽  
Feina Shi ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Web Of Science ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Exclusion Criteria ◽  
Total Resection ◽  
Free Survival

BackgroundIt still remains unclear whether patients with atypical meningioma (AM) could benefit from postoperative adjuvant radiotherapy (PORT) after gross-total resection (GTR).ObjectiveExploring the effectiveness of PORT on AM patients after GTR.MethodsLiteratures on PubMed, Embase, Web of science, and Scopus databases published between January 2000 and January 2019 were searched. After the selection based on the certain exclusion criteria, the Newcastle-Ottawa evaluation scale was used to evaluate the quality of the included literatures. Finally, a meta-analysis was conducted to analyze the effectiveness of PORT on local control (LC), progression-free survival (PFS) and overall survival (OS) in atypical meningioma patients after GTR.ResultsA total of 17 articles with 2,008 AM patients were included in the meta-analysis. The 5-year LC, 5-year PFS, and 5-year OS rates were 82.2, 84.1, and 79.0%, respectively, for AM patients receiving PORT after GTR, and they were 71.0, 71.9, and 81.5%, respectively, for those not receiving PORT after GTR. PORT could significantly improve 5-year LC rate (OR [95% Cl] = 2.59 [1.40–4.81], P = 0.002) and 5-year PFS rate (OR [95% Cl] = 1.99 [1.35–2.95], P = 0.001), but did not significantly improve 5-year OS rate (OR [95% Cl] = 1.07 [0.60–1.91], P = 0.828).ConclusionPORT could improve the 5-year LC rate and 5-year PFS rate in AM patients after GTR. AM patients might benefit from PORT after GTR.

The Role of Adjuvant Radiotherapy After Gross Total Resection of Atypical Meningiomas

2015 ◽  
Vol 83 (5) ◽  
pp. 808-815 ◽  
Author(s):  
Shaakir Hasan ◽  
Michael Young ◽  
Trevine Albert ◽  
Ashish H. Shah ◽  
Christian Okoye ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Gross Total Resection ◽  
Total Resection ◽  
Atypical Meningiomas

Revisiting Adjuvant Radiotherapy After Gross Total Resection of World Health Organization Grade II Meningioma

2017 ◽  
Vol 103 ◽  
pp. 655-663 ◽  
Author(s):  
Christopher S. Graffeo ◽  
Heather E. Leeper ◽  
Avital Perry ◽  
Joon H. Uhm ◽  
Daniel J. Lachance ◽  
...  
Keyword(s):  
World Health Organization ◽  
Adjuvant Radiotherapy ◽  
World Health ◽  
Gross Total Resection ◽  
Total Resection ◽  
Grade Ii ◽  
Health Organization

Preoperative and Histological Predictors of Recurrence and Survival in Atypical Meningioma After Initial Gross Total Resection

2019 ◽  
Vol 128 ◽  
pp. e148-e156 ◽  
Author(s):  
Joshua Loewenstern ◽  
William Shuman ◽  
John W. Rutland ◽  
Remi A. Kessler ◽  
Karan M. Kohli ◽  
...  
Keyword(s):  
Atypical Meningioma ◽  
Gross Total Resection ◽  
Total Resection ◽  
Predictors Of Recurrence

Tumor control after surgery for spinal myxopapillary ependymomas: distinct outcomes in adults versus children

2013 ◽  
Vol 19 (4) ◽  
pp. 471-476 ◽  
Author(s):  
William B. Feldman ◽  
Aaron J. Clark ◽  
Michael Safaee ◽  
Christopher P. Ames ◽  
Andrew T. Parsa
Keyword(s):  
Recurrence Rate ◽  
Adjuvant Radiotherapy ◽  
Pediatric Patients ◽  
Cauda Equina ◽  
Extent Of Resection ◽  
Gross Total Resection ◽  
Tumor Control ◽  
Recurrence Rates ◽  
Total Resection ◽  
Who Grade

Object Myxopapillary ependymomas (MPEs) are rare WHO Grade I tumors found in the conus medullaris, cauda equina, and filum terminale. Treatment generally consists of resection with or without adjuvant radiotherapy. Evidence-based guidelines for surgical management are lacking due to the rarity of this tumor. Methods An English-language PubMed search was performed using the key words “myxopapillary” and “ependymoma.” Reports describing fewer than 3 patients or those lacking data on the extent of resection or radiotherapy were excluded. A total of 28 articles describing 475 patients met the authors' inclusion criteria. Patients were grouped by extent of resection and whether or not they underwent adjuvant radiotherapy. Differences in recurrence rates were assessed by chi-square test. Results The overall recurrence rate was 15.5% in patients treated by gross-total resection (GTR) and 32.6% in patients treated by subtotal resection (STR), irrespective of whether they underwent adjuvant therapy (p < 0.001). Regardless of the extent of resection, adjuvant radiotherapy was not associated with a decrease in recurrence rates. The overall recurrence rate was 15.6% in patients who underwent GTR and radiotherapy compared with 15.9% in patients who underwent GTR alone (p = 0.58), and it was 29.3% in patients who underwent STR and radiotherapy compared with 35.1% in those who underwent STR alone (p = 0.53). The difference between recurrence rates for patients who underwent GTR alone versus STR and radiotherapy was statistically significant (p = 0.02). Subgroup analysis demonstrated significantly higher recurrence rates in pediatric patients compared with adults (40.5% vs 23.4%, respectively; p = 0.02). Even in the setting of GTR alone, recurrence rates were higher in pediatric patients (65% vs 7.6%; p < 0.001). Conclusions Gross-total resection alone is associated with decreased recurrence rates compared with STR with or without radiotherapy. The authors' results suggest that treatment goals should include attempted GTR whenever possible. The observation that children benefitted from radiation therapy to a greater extent than did adults suggests that biological differences between tumors in these patient populations warrants more rigorous scientific studies.

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