脑膜瘤是最常见的原发性脑肿瘤,通常被认为是良性的。然而,一种罕见的脑膜瘤亚组,被列为世界卫生组织(WHO)III级脑膜瘤,可以表现出极其攻击性的行为和高复发率。尽管正在进行研究,该脑膜瘤亚组的临床结局数据仍然有限.
对2000年至2018年在科英布拉大学医院中心诊断出的WHOIII级脑膜瘤患者的病历进行回顾性分析,并分析了几个感兴趣的变量及其与患者生存的关系。
在最终分析中纳入的26名患者中,23人患有间变性脑膜瘤,2人患有乳头状脑膜瘤,1人患有横纹肌样脑膜瘤。中位总生存期和中位无进展生存期分别为2.45和1.22年,分别。1年、2年和5年的总生存率为73%,57%,35%,分别。辅助放疗与亚完全切除的脑膜瘤的生存率提高相关,但与大体完全切除的脑膜瘤无关。总体全切除与次全切除相比,总生存率有提高的趋势,但是这种差异没有达到统计学意义。
这项研究提供了对WHOIII级脑膜瘤的临床结果的见解,并表明辅助放疗可能对接受全切除的患者没有益处。这种罕见的脑膜瘤仍预示着毁灭性的预后,这些患者的切除程度和辅助治疗的影响需要进一步澄清。
Meningiomas are the most common primary brain tumors and are generally considered benign. However, a rare subgroup of meningiomas, classified as World Health Organization (WHO) grade III meningiomas, can show extremely aggressive behavior and high rates of recurrence. Despite ongoing research, data on the clinical outcome of this subgroup of meningiomas are still limited.
Medical records of patients with WHO grade III meningiomas diagnosed between 2000 and 2018 at the Coimbra University Hospital Center were retrospectively reviewed and several variables of interest and their relation to patients\' survival were analyzed.
Of the 26 patients included in the final analysis, 23 had anaplastic meningiomas, 2 had papillary meningiomas, and 1 had a rhabdoid meningioma. Median overall survival and median progression-free survival were 2.45 and 1.22 years, respectively. Overall survival at 1, 2 and 5 years was 73%, 57%, and 35%, respectively. Adjuvant radiotherapy correlated with improved survival for subtotally resected meningiomas but not for gross totally resected meningiomas. There was a trend toward improved overall survival with gross total resection versus subtotal resection, but this difference failed to reach statistical significance.
This study provides insight into the clinical outcomes of WHO grade III meningiomas and suggests that adjuvant radiotherapy may not be beneficial for patients who underwent gross total resection. This rare subset of meningiomas still portends a devastating prognosis and the impact of extent of resection and adjuvant therapies in these patients needs further clarification.