Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery: Importance of the histopathological grade and MIB-1 index

K. Nakaya, M. Chernov, H. Kasuya, M. Izawa, M. Hayashi, K. Kato, O. Kubo, Y. Muragaki, Hiroshi Iseki, T. Hori, Y. Okada, K. Takakura

Research output: Contribution to journalArticle

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Abstract

Introduction: The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). Patients and Methods: Thirty-four intracranial meningiomas with known detailed histopathological diagnosis were analyzed. Tumors of WHO histopathological grades I, II, and III were diagnosed in 24, 3, and 7 cases, respectively. The median MIB-1 index was 1.3% (range: 031.9%). In 14 cases the MIB-1 index was 3.0% and more. In 26 cases the treatment was done at the time of tumor recurrence. Median volume of the neoplasm at the time of GKR was 4.1mL (range: 0.443.1mL). Median marginal dose was 12Gy (range: 819Gy). Median length of follow-up constituted 63 months (range: 19132 months). Results: Actuarial progression-free survival at 1, 3, 5, and 10 years constituted 100, 94, 83, and 58%, respectively. Histopathological grade II or III (p<0.0001), MIB-1 index 3% and more (p=0.0004), and non-skull base location (p=0.0026) of the tumor showed negative associations with progression-free survival in multivariate analyses. Actuarial progression-free survival at 5 years after GKR for benign and non-benign meningiomas constituted 100 and 45%, respectively (p<0.0001). Conclusion: Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalMinimally Invasive Neurosurgery
Volume52
Issue number5-6
DOIs
Publication statusPublished - 2009
Externally publishedYes

Fingerprint

Radiosurgery
Meningioma
Disease-Free Survival
Neoplasms
Multivariate Analysis
Retrospective Studies
Recurrence
Therapeutics
Growth

Keywords

  • Gamma knife radiosurgery
  • Histopathological grade
  • Management
  • Meningioma
  • MIB-1 index
  • Outcome

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery : Importance of the histopathological grade and MIB-1 index. / Nakaya, K.; Chernov, M.; Kasuya, H.; Izawa, M.; Hayashi, M.; Kato, K.; Kubo, O.; Muragaki, Y.; Iseki, Hiroshi; Hori, T.; Okada, Y.; Takakura, K.

In: Minimally Invasive Neurosurgery, Vol. 52, No. 5-6, 2009, p. 216-221.

Research output: Contribution to journalArticle

Nakaya, K, Chernov, M, Kasuya, H, Izawa, M, Hayashi, M, Kato, K, Kubo, O, Muragaki, Y, Iseki, H, Hori, T, Okada, Y & Takakura, K 2009, 'Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery: Importance of the histopathological grade and MIB-1 index', Minimally Invasive Neurosurgery, vol. 52, no. 5-6, pp. 216-221. https://doi.org/10.1055/s-0029-1243244
Nakaya, K. ; Chernov, M. ; Kasuya, H. ; Izawa, M. ; Hayashi, M. ; Kato, K. ; Kubo, O. ; Muragaki, Y. ; Iseki, Hiroshi ; Hori, T. ; Okada, Y. ; Takakura, K. / Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery : Importance of the histopathological grade and MIB-1 index. In: Minimally Invasive Neurosurgery. 2009 ; Vol. 52, No. 5-6. pp. 216-221.
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title = "Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery: Importance of the histopathological grade and MIB-1 index",
abstract = "Introduction: The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). Patients and Methods: Thirty-four intracranial meningiomas with known detailed histopathological diagnosis were analyzed. Tumors of WHO histopathological grades I, II, and III were diagnosed in 24, 3, and 7 cases, respectively. The median MIB-1 index was 1.3{\%} (range: 031.9{\%}). In 14 cases the MIB-1 index was 3.0{\%} and more. In 26 cases the treatment was done at the time of tumor recurrence. Median volume of the neoplasm at the time of GKR was 4.1mL (range: 0.443.1mL). Median marginal dose was 12Gy (range: 819Gy). Median length of follow-up constituted 63 months (range: 19132 months). Results: Actuarial progression-free survival at 1, 3, 5, and 10 years constituted 100, 94, 83, and 58{\%}, respectively. Histopathological grade II or III (p<0.0001), MIB-1 index 3{\%} and more (p=0.0004), and non-skull base location (p=0.0026) of the tumor showed negative associations with progression-free survival in multivariate analyses. Actuarial progression-free survival at 5 years after GKR for benign and non-benign meningiomas constituted 100 and 45{\%}, respectively (p<0.0001). Conclusion: Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.",
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T1 - Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery

T2 - Importance of the histopathological grade and MIB-1 index

AU - Nakaya, K.

AU - Chernov, M.

AU - Kasuya, H.

AU - Izawa, M.

AU - Hayashi, M.

AU - Kato, K.

AU - Kubo, O.

AU - Muragaki, Y.

AU - Iseki, Hiroshi

AU - Hori, T.

AU - Okada, Y.

AU - Takakura, K.

PY - 2009

Y1 - 2009

N2 - Introduction: The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). Patients and Methods: Thirty-four intracranial meningiomas with known detailed histopathological diagnosis were analyzed. Tumors of WHO histopathological grades I, II, and III were diagnosed in 24, 3, and 7 cases, respectively. The median MIB-1 index was 1.3% (range: 031.9%). In 14 cases the MIB-1 index was 3.0% and more. In 26 cases the treatment was done at the time of tumor recurrence. Median volume of the neoplasm at the time of GKR was 4.1mL (range: 0.443.1mL). Median marginal dose was 12Gy (range: 819Gy). Median length of follow-up constituted 63 months (range: 19132 months). Results: Actuarial progression-free survival at 1, 3, 5, and 10 years constituted 100, 94, 83, and 58%, respectively. Histopathological grade II or III (p<0.0001), MIB-1 index 3% and more (p=0.0004), and non-skull base location (p=0.0026) of the tumor showed negative associations with progression-free survival in multivariate analyses. Actuarial progression-free survival at 5 years after GKR for benign and non-benign meningiomas constituted 100 and 45%, respectively (p<0.0001). Conclusion: Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.

AB - Introduction: The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). Patients and Methods: Thirty-four intracranial meningiomas with known detailed histopathological diagnosis were analyzed. Tumors of WHO histopathological grades I, II, and III were diagnosed in 24, 3, and 7 cases, respectively. The median MIB-1 index was 1.3% (range: 031.9%). In 14 cases the MIB-1 index was 3.0% and more. In 26 cases the treatment was done at the time of tumor recurrence. Median volume of the neoplasm at the time of GKR was 4.1mL (range: 0.443.1mL). Median marginal dose was 12Gy (range: 819Gy). Median length of follow-up constituted 63 months (range: 19132 months). Results: Actuarial progression-free survival at 1, 3, 5, and 10 years constituted 100, 94, 83, and 58%, respectively. Histopathological grade II or III (p<0.0001), MIB-1 index 3% and more (p=0.0004), and non-skull base location (p=0.0026) of the tumor showed negative associations with progression-free survival in multivariate analyses. Actuarial progression-free survival at 5 years after GKR for benign and non-benign meningiomas constituted 100 and 45%, respectively (p<0.0001). Conclusion: Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.

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KW - Histopathological grade

KW - Management

KW - Meningioma

KW - MIB-1 index

KW - Outcome

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