Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Chin Med J (Engl). 2011 Aug;124(15):2387-91.
Atypical meningioma is one of the rare subtypes of meningioma, which is lacking of optimal consensus on treatment strategies. This study aimed to investigate the radical treatment strategies to improve the long-term outcome of recurrent atypical meningiomas.
The prognostic factors including the age and gender of patients; the location, histology, recurrence pattern and mitotic cell rate of the tumors; and the resection extents, surgical strategies and adjuvant therapies of 15 cases of recurrent atypical meningiomas were analyzed retrospectively.
The age and gender of patients were not associated with tumor recurrence. However, high recurrence rates and poor prognosis for atypical meningiomas were associated with the high mitotic cell rate, failure to achieve Simpson grade I-II resection, and without the dura and bone flap replacement intraoperatively. Post-operative radiotherapy improved the outcomes of tumors in patients after the second surgery.
Radical treatment strategies such as dura and bone flap replacements and radiotherapy should be considered in patients diagnosed with atypical meningiomas.
非典型脑膜瘤是脑膜瘤的罕见亚型之一，其治疗策略缺乏最佳共识。本研究旨在探讨根治性治疗策略，以改善复发性非典型脑膜瘤的长期预后。
回顾性分析 15 例复发性非典型脑膜瘤患者的年龄和性别、肿瘤部位、组织学、复发模式和有丝分裂细胞率，以及肿瘤切除程度、手术策略和辅助治疗等预后因素。
患者的年龄和性别与肿瘤复发无关。然而，高有丝分裂细胞率、未能达到 Simpson 分级 I-II 切除，以及术中未行硬脑膜和骨瓣置换与非典型脑膜瘤的高复发率和不良预后相关。第二次手术后行放疗可改善肿瘤患者的预后。
对于诊断为非典型脑膜瘤的患者，应考虑采用硬脑膜和骨瓣置换和放疗等根治性治疗策略。
