Department of Neurosurgery, Neurological Institute, Cleveland, Ohio, USA; Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland, Ohio, USA.
Department of Neurosurgery, Neurological Institute, Cleveland, Ohio, USA.
World Neurosurg. 2020 Sep;141:e334-e340. doi: 10.1016/j.wneu.2020.05.120. Epub 2020 May 21.
Clear cell meningioma (CCM) is a rare histologic variant, accounting for only 0.2%-0.8% of all meningiomas. Given their relative infrequency, few cases have been reported. We have presented one of the largest series of patients with intracranial CCM and reported the treatments and outcomes of these patients.
Patients with histologically proven CCM from 2003 to 2018 were identified for inclusion in the present study. Relevant clinical and radiographic data were obtained via retrospective review and analyzed. Kaplan-Meier and Cox proportional hazards analyses were used to compare overall and progression-free survival.
A total of 35 patients had undergone surgical resection for CCM, including 18 women and 17 men, with a mean age of 59.3 years. Gross total resection was achieved in 22 patients (62.9%), and 11 patients (31.4%) had received adjuvant postoperative radiotherapy. Tumors recurred in 17 patients (48.6%), with a mean time to recurrence of 31.3 months. The mean postoperative follow-up was 66.3 months. On multivariable analysis, adjuvant radiotherapy and gross total tumor resection were both independently associated with prolonged progression-free survival (P < 0.033), although not with overall survival (P >0.274).
The data from the present series of 35 patients with CCM have shown distinct contrasts to previous series, with an older mean age and a nearly 1:1 male/female ratio. Although gross total resection and adjuvant postoperative radiotherapy were both independently associated with longer progression-free survival for patients with CCM, tumor recurrence has remained a challenge in the treatment of these patients.
透明细胞脑膜瘤（CCM）是一种罕见的组织学变体，仅占所有脑膜瘤的 0.2%-0.8%。由于其相对罕见，报道的病例很少。我们报告了一组最大的颅内 CCM 患者，并报告了这些患者的治疗和结果。
本研究纳入了 2003 年至 2018 年间经组织学证实的 CCM 患者。通过回顾性分析获得了相关的临床和影像学数据，并进行了分析。使用 Kaplan-Meier 和 Cox 比例风险分析比较总生存期和无进展生存期。
共有 35 例患者接受了 CCM 的手术切除，其中 18 例为女性，17 例为男性，平均年龄为 59.3 岁。22 例患者（62.9%）达到了大体全切除，11 例患者（31.4%）接受了术后辅助放疗。17 例患者（48.6%）肿瘤复发，平均复发时间为 31.3 个月。平均术后随访时间为 66.3 个月。多变量分析显示，辅助放疗和大体全切除肿瘤均与无进展生存期延长独立相关（P < 0.033），但与总生存期无关（P >0.274）。
本系列 35 例 CCM 患者的数据与以往的系列数据明显不同，平均年龄较大，男女比例接近 1:1。尽管大体全切除和术后辅助放疗均与 CCM 患者的无进展生存期延长独立相关，但肿瘤复发仍然是这些患者治疗的挑战。
