1MD Undergraduate Program, University of British Columbia.
2Division of Neurosurgery, University of British Columbia, Vancouver.
J Neurosurg. 2023 Aug 11;140(2):393-403. doi: 10.3171/2023.6.JNS23465. Print 2024 Feb 1.
Grade 3 meningioma represents a rare meningioma subtype, for which limited natural history data are available. The objective of this study was to identify demographics and pathologic characteristics, clinical and functional status outcomes, and prognostic factors in an international cohort of grade 3 meningioma patients.
Clinical and histopathological data were collected for patients treated at 7 sites across North America and Europe between 1991 and 2022.
A total of 103 patients (54% female, median age 65 [IQR 52, 72] years) were included. Sixty-seven (65%) patients had de novo grade 3 lesions, whereas 29 (28%) had malignant transformations of lower-grade meningiomas. All patients underwent initial resection of their tumor. Patients were followed for a median of 46 (IQR 24, 108) months, during which time there were 65 (73%) recurrences and 50 (49%) deaths. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66% (95% CI 56%-77%) and 37% (95% CI 28%-48%), respectively. Age ≥ 65 years and male sex were independent predictors of worse OS and PFS in multivariate regression analysis, while postoperative radiotherapy was independently associated with improved OS. Karnofsky Performance Status (KPS) remained stable relative to baseline over 5 years postdiagnosis among participants who were alive at the end of the follow-up period.
This large multicenter study provides insight into the longitudinal outcomes of grade 3 meningioma, with respect to recurrence, survival, and functional status. This study affirms the survival benefit conferred by radiotherapy in this population and suggests good functional status outcomes for patients surviving to 5 years postoperatively.
3 级脑膜瘤是一种罕见的脑膜瘤亚型，目前关于其自然病史的数据有限。本研究旨在确定 3 级脑膜瘤患者国际队列的人口统计学和病理学特征、临床和功能状态结局以及预后因素。
收集了 1991 年至 2022 年期间在北美和欧洲 7 个地点接受治疗的患者的临床和组织病理学数据。
共纳入 103 例患者（54%为女性，中位年龄 65[IQR 52，72]岁）。67 例（65%）患者为新发 3 级病变，29 例（28%）为低级别脑膜瘤的恶性转化。所有患者均接受了肿瘤的初始切除术。患者中位随访时间为 46（IQR 24，108）个月，期间有 65 例（73%）复发和 50 例（49%）死亡。5 年总生存率（OS）和无进展生存率（PFS）分别为 66%（95%CI 56%-77%）和 37%（95%CI 28%-48%）。多变量回归分析显示，年龄≥65 岁和男性是 OS 和 PFS 较差的独立预测因素，而术后放疗与 OS 改善独立相关。在随访期末仍存活的患者中，Karnofsky 表现状态（KPS）在诊断后 5 年内相对基线保持稳定。
这项大型多中心研究提供了关于 3 级脑膜瘤复发、生存和功能状态的纵向结果的见解。本研究证实了放疗在该人群中的生存获益，并表明术后 5 年存活患者的功能状态结局良好。
