Department of Neurosurgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland.
Department of Neurosurgery, Angers University Hospitals, Rue Larrey 4, 49100, Angers, France.
Sci Rep. 2020 Jul 8;10(1):11220. doi: 10.1038/s41598-020-68177-x.
Atypical or malignant transformation (AT/MT) has been described in WHO grade I meningiomas. Our aim was to identify predictive factors of AT/MT at recurrence. A total of N = 15 WHO grade increases were observed in N = 13 patients (0.96% of the study population, risk of transformation of 0.12% per patient-year follow-up). Patients with and without progression at recurrence were similar regarding age, gender distribution, skull-base location, bone infiltration, and Simpson grades. Recurrence-free survival was lower in patients with transformation (5 ± 4.06 years versus 7.3 ± 5.4 years; p = 0.03). Among patient age, gender, skull base location, extent of resection or post-operative RT, no predictor of AT/MT was identified, despite a follow-up of 10,524 patient-years. The annual risk of transformation of WHO grade I meningiomas was 0.12% per patient-year follow-up. Despite the important number of patients included and their extended follow-up, we did not identify any risk factor for transformation. A total of 1,352 patients with surgically managed WHO grade I meningioma from a mixed retro-and prospective database with mean follow-up of 9.2 years ± 5.7 years (0.3-20.9 years) were reviewed. Recurring tumors at the site of initial surgery were considered as recurrence.
非典型或恶性转化（AT/MT）已在 WHO 分级 I 脑膜瘤中描述。我们的目的是确定复发时 AT/MT 的预测因素。在 N = 13 名患者（研究人群的 0.96%，每位患者每年随访的转化风险为 0.12%）中观察到总共 N = 15 次 WHO 分级增加。复发时进展和无进展的患者在年龄、性别分布、颅底位置、骨浸润和 Simpson 分级方面相似。转化患者的无复发生存率较低（5 ± 4.06 年与 7.3 ± 5.4 年；p = 0.03）。尽管随访时间长达 10,524 患者年，但在患者年龄、性别、颅底位置、切除程度或术后放疗方面，没有发现 AT/MT 的预测因素。WHO 分级 I 脑膜瘤的年转化风险为每位患者每年随访 0.12%。尽管纳入了大量患者并进行了延长随访，但我们未发现任何转化的危险因素。我们回顾了来自回顾性和前瞻性混合数据库的 1,352 名接受手术治疗的 WHO 分级 I 脑膜瘤患者，平均随访 9.2 ± 5.7 年（0.3-20.9 年）。将初始手术部位的复发性肿瘤视为复发。
