Primary resected meningiomas: relapses and proliferation markers.
Relapses of meningiomas are a well known phenomenon during follow-up. The significance of sex, age, surgical treatment and mitotic frequency with regard to relapses are still a matter of debate.


METHODS
The study included 125 meningioma patients who underwent surgical intervention between 1986 and 1997 They were in follow-up for 3, 5, 10 and 15 years; they were grouped as "stable" or "relapsing" tumours. The follow-up was based on magnetic resonance image (MRI) and tomodensitometry (TDM). The labelling index for Ki67 and PCNA (proliferation markers) was scored at resection. Risk factors for relapse were reviewed using univariate analysis and Cox hazards model.


RESULTS
One hundred and twenty-five patients were under medical control of whom 26 showed a relapse. Among them 25 arose from subtotal resected tumours and 1 was a recurrence. Relapses comprised 16 females and 10 males. Tumour relapses at 3,5,10 and 15 years were, respectively, 8.8%, 13.6%, 17.6% and 20.8%. Proliferation markers, at group level, were statistically significantly different to distinguish stable from relapsing and malignant from benign meningiomas. Factors significantly associated with tumour relapse in univariate analysis were incomplete resection, histopathology and proliferation markers. In multivariate analysis the proliferation markers and incomplete resection were the only significant risk factors (p<0.05) for relapse.


CONCLUSIONS
To avoid relapses of meningiomas, total resection is recommended. The resection type and proliferation markers are predictive factors for tumour relapse. The proliferation markers cannot be applied at the individual level.
Kalala
Jean-Pierre
JP
Department of Neurosurgery, University Hospital, De Pintelaan 185, Ghent, Belgium.
Caemaert
Jacques
J
De Ridder
Leo
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D049109:Cell Proliferation; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008579:Meningioma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen