Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hněvotínská 1333/5, I. P. Pavlova 6, 779 00, Olomouc, Czech Republic.
Department of Neurosurgery, Svet Zdravia Hospital Michalovce, Michalovce, Slovak Republic.
Acta Neurochir (Wien). 2020 Sep;162(9):2165-2176. doi: 10.1007/s00701-020-04336-3. Epub 2020 Apr 24.
As the predictive role of many risk factors for parasagittal meningioma (PM) recurrence remains unclear, the objective of the meta-analysis was to make a comprehensive assessment of the predictive value of selected risk factors in these lesions.
Studies including data on selected risk factors, such as histology, tumor and sinus resection, sinus invasion, tumor localization, and immediate postoperative radiotherapy for PMs recurrence, were searched in the NCBI/NLM PubMed/MEDLINE, EBM Reviews/Cochrane Central, ProQuest, and Scopus databases, and analyzed using random effects modeling.
Thirteen observational studies involving 1243 patients met the criteria for inclusion in the meta-analysis. WHO grading of meningiomas was identified as the most powerful risk factor for recurrence. WHO grade II meningiomas (OR 11.61; 95% CI 4.43-30.43; P < .01; I = 31%) or composite group of WHO grades II and III (OR 14.84; 95% CI 5.10-43.19; P < .01; I = 48%) had a significantly higher risk of recurrence than benign lesions. Moreover, an advanced sinus involvement (types IV-VI according to the Sindou classification) (OR 3.49; 95% CI 1.30-9.33; P = .01; I = 0%) and partial tumor resection (Simpson grades III-V) (OR 2.73; 95% CI 1.41-5.30; P = .03; I = 52%) were associated with a significantly higher risk of recurrence than their counterparts.
Among the selected risk factors, high-grade WHO lesions, advanced sinus invasion, and partial tumor resection were associated with a higher risk of PM recurrence, with WHO grading system being the most powerful risk factor.
由于许多预测因素对矢状旁脑膜瘤（PM）复发的预测作用仍不清楚，因此本次荟萃分析的目的是全面评估这些病变中选定危险因素的预测价值。
在 NCBI/NLM PubMed/MEDLINE、EBM Reviews/Cochrane Central、ProQuest 和 Scopus 数据库中检索了包含选定危险因素（如组织学、肿瘤和窦切除术、窦侵犯、肿瘤定位以及 PM 复发后的即刻术后放疗）数据的研究，并使用随机效应模型进行了分析。
共有 13 项符合纳入标准的观察性研究纳入了本次荟萃分析。脑膜瘤的世界卫生组织分级被确定为复发的最有力危险因素。WHO 分级 II 型脑膜瘤（OR 11.61；95%CI 4.43-30.43；P < 0.01；I = 31%）或 WHO 分级 II 和 III 型的复合组（OR 14.84；95%CI 5.10-43.19；P < 0.01；I = 48%）的复发风险显著高于良性病变。此外，高级窦受累（Sindou 分类的 IV-VI 型）（OR 3.49；95%CI 1.30-9.33；P = 0.01；I = 0%）和部分肿瘤切除（Simpson 分级 III-V）（OR 2.73；95%CI 1.41-5.30；P = 0.03；I = 52%）与复发风险显著增加相关。
在所选择的危险因素中，高级别 WHO 病变、高级窦侵犯和部分肿瘤切除与 PM 复发风险增加相关，而 WHO 分级系统是最有力的危险因素。
