Behling Felix, Hempel Johann-Martin, Schittenhelm Jens
Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, Germany.
Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard-Karls-University Tübingen, 72076 Tübingen, Germany.
Cancers (Basel). 2021 Jun 29;13(13):3259. doi: 10.3390/cancers13133259.
Most meningiomas are slow growing tumors arising from the arachnoid cap cells and can be cured by surgical resection or radiation therapy in selected cases. However, recurrent and aggressive cases are also quite common and challenging to treat due to no established treatment alternatives. Assessment of the risk of recurrence is therefore of utmost importance and several prognostic clinical and molecular markers have been established. Additionally, the identification of invasive growth of meningioma cells into CNS tissue was demonstrated to lead to a higher risk of recurrence and was therefore integrated into the WHO classification of CNS tumors. However, the evidence for its prognostic impact has been questioned in subsequent studies and its exclusion from the next WHO classification proposed. We were recently able to show the prognostic impact of CNS invasion in a large comprehensive retrospective meningioma cohort including other established prognostic factors. In this review we discuss the growing experiences that have been gained on this matter, with a focus on the currently nonuniform histopathological assessment, imaging characteristics and intraoperative sampling as well as the overall outlook on the future role of this potential prognostic factor.
大多数脑膜瘤是起源于蛛网膜帽细胞的生长缓慢的肿瘤，在某些情况下可通过手术切除或放射治疗治愈。然而，复发和侵袭性病例也相当常见，由于没有既定的治疗方案，治疗具有挑战性。因此，评估复发风险至关重要，并且已经建立了几种预后临床和分子标志物。此外，已证明脑膜瘤细胞侵入中枢神经系统组织会导致更高的复发风险，因此被纳入世界卫生组织中枢神经系统肿瘤分类。然而，其预后影响的证据在随后的研究中受到质疑，并提议将其排除在下一版世界卫生组织分类之外。我们最近能够在一个大型综合性回顾性脑膜瘤队列中显示中枢神经系统侵袭的预后影响，该队列包括其他既定的预后因素。在这篇综述中，我们讨论了在这个问题上获得的越来越多的经验，重点是目前不统一的组织病理学评估、影像学特征和术中采样，以及这个潜在预后因素未来作用的总体展望。
