Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.
J Neurooncol. 2021 Jan;151(2):307-312. doi: 10.1007/s11060-020-03668-5. Epub 2021 Jan 4.
Clear cell meningioma (CCM) is a rare WHO grade II meningioma variant, characterized by aggressive features and a high tumor recurrence rate. In this study, we compared overall and progression-free survivals between CCMs and other WHO grade II meningiomas.
A retrospective institutional database review was performed to identify all patients who underwent surgical resection of a WHO grade II meningioma between 1997 and 2019. Overall survival and progression-free survival were compared between patients with clear cell meningiomas and patients with other WHO grade II meningiomas. Multivariable Cox proportional-hazards analysis was used to identify independent predictors of tumor recurrence and survival.
We included a total of 214 patients in this study (43 CCMs, 171 other WHO grade II meningiomas). Patients with CCMs had significantly shorter progression-free (p = 0.001) and overall (p = 0.026) survivals than patients with other grade II meningiomas. In multivariable analysis, clear cell histology was a significant and powerful independent predictor of tumor recurrence (HR 1.93; 95% CI 1.14-3.26) when controlling for tumor location, extent of resection, and adjuvant radiation. In multivariable analysis, clear cell histology correlated with increased mortality (HR 1.96, 95% CI 0.97-3.94), though this was not statistically significant.
This is the first study to compare overall and progression-free survivals between CCMs and other WHO grade II meningiomas. Clear cell histology predicts a higher risk of tumor recurrence and mortality than other grade II histologies. Future studies may help to understand the impact of these findings and the treatment implications.
透明细胞脑膜瘤（CCM）是一种罕见的 WHO 分级 II 型脑膜瘤变异型，其特征为侵袭性特征和高肿瘤复发率。本研究比较了 CCM 与其他 WHO 分级 II 型脑膜瘤之间的总生存率和无进展生存率。
对 1997 年至 2019 年间接受手术切除的所有 WHO 分级 II 型脑膜瘤患者进行回顾性的机构数据库审查。比较透明细胞脑膜瘤患者和其他 WHO 分级 II 型脑膜瘤患者的总生存率和无进展生存率。使用多变量 Cox 比例风险分析来确定肿瘤复发和生存的独立预测因素。
本研究共纳入 214 例患者（43 例 CCM，171 例其他 WHO 分级 II 型脑膜瘤）。CCM 患者的无进展生存率（p=0.001）和总生存率（p=0.026）明显短于其他 WHO 分级 II 型脑膜瘤患者。在多变量分析中，控制肿瘤位置、切除程度和辅助放疗后，透明细胞组织学是肿瘤复发的显著和强大的独立预测因素（HR 1.93；95%CI 1.14-3.26）。在多变量分析中，透明细胞组织学与死亡率增加相关（HR 1.96，95%CI 0.97-3.94），尽管这在统计学上无显著意义。
这是第一项比较 CCM 与其他 WHO 分级 II 型脑膜瘤之间总生存率和无进展生存率的研究。透明细胞组织学预测肿瘤复发和死亡率的风险高于其他分级 II 型组织学。未来的研究可能有助于了解这些发现的影响和治疗意义。
