Ammanuel Simon G, Stenerson Matthew, Staniszewski Thomas, Kalluri Manasa, Lee Benjamin, Nico Elsa, Ahmed Azam S
Department of Neurological Surgery, University of Wisconsin Hospitals and Clinics, Madison, USA.
Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Cureus. 2025 Apr 10;17(4):e82033. doi: 10.7759/cureus.82033. eCollection 2025 Apr.
Objective Meningiomas commonly recur following gross total resection (GTR), and the risk of recurrence is difficult to predict using current classification schemes such as the World Health Organization (WHO) tumor grade. This study aimed to create a predictive model of recurrence risk following GTR of WHO grade 1 meningiomas based on histopathological and epidemiological factors. Methods A retrospective chart review was completed for all patients at our institution who underwent their first surgery for a WHO grade 1 meningioma between 2017 and 2022. Those with genetic predispositions, such as neurofibromatosis type 2, were excluded. Baseline characteristics, including histopathology findings, were obtained, and we used a Risk-calibrated Superspase Linear Integer Model (Risk-SLIM) with a five-fold cross-validation (CV) to create a predictive model of recurrence over an average follow-up of three years. Results Univariate analysis of our selected variables revealed a significant predictive association between WHO grade 1 meningioma recurrence and subtotal resection but not with any other variable. However, the meningioma recurrence score (MRS) generated by our machine learning algorithm revealed multiple predictive factors of recurrence, including age, female gender, and various histopathologic features, including the Ki-67/MIB-1 index. Conclusions Machine learning algorithms like the one we present here may help identify patients at high risk of recurrence of their WHO grade 1 meningioma, and they are more likely to benefit from closer postoperative surveillance or adjuvant treatment, even when GTR is achieved.
目的 脑膜瘤在全切除(GTR)后常复发,使用当前的分类方案(如世界卫生组织(WHO)肿瘤分级)难以预测复发风险。本研究旨在基于组织病理学和流行病学因素创建WHO 1级脑膜瘤GTR后复发风险的预测模型。 方法 对2017年至2022年间在本机构首次接受WHO 1级脑膜瘤手术的所有患者进行回顾性病历审查。排除有遗传易感性的患者,如2型神经纤维瘤病患者。获取包括组织病理学结果在内的基线特征,并使用具有五重交叉验证(CV)的风险校准超空间线性整数模型(Risk-SLIM)创建一个在平均三年随访期内的复发预测模型。 结果 对我们所选变量的单因素分析显示,WHO 1级脑膜瘤复发与次全切除之间存在显著的预测关联,但与其他任何变量均无关联。然而,我们的机器学习算法生成的脑膜瘤复发评分(MRS)显示了多个复发预测因素,包括年龄、女性性别以及各种组织病理学特征,包括Ki-67/MIB-1指数。 结论 我们在此展示的这类机器学习算法可能有助于识别WHO 1级脑膜瘤复发风险高的患者,即使实现了GTR,他们也更有可能从更密切的术后监测或辅助治疗中获益。
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