title: Relationship between malignant subtypes of meningioma and clinical outcome.
abstract: We evaluated the relationship between histological malignant subtypes (WHO grade II or III) of meningioma and clinical outcome. Of 485 patients treated surgically for intracranial meningioma at our hospital between 1994 and 2004, 49 (10%; 18 male, 31 female) had potentially malignant features. The histological tumor subtypes within this group of patients included: atypical (n=23); clear cell (n=3); chordoid (n=5); rhabdoid (n=16); and anaplastic (n=4). Correlations among prognosis, recurrence, and the following factors were analyzed for each histological subtype: the Simpson grade of surgical resection (grades I-III vs. grade IV), tumor location (convexity vs. other), the Ki-67 index, and use of postoperative radiotherapy. The median value of the Ki-67 index was 16.2% (range: 1.0-57.2%). The surgical resections were of Simpson grades I-III and IV in 43 and six of the 49 patients, respectively. Tumors recurred after the initial surgical resection in 14 of the 49 patients. In view of the relatively high proportion of malignant subtypes (10%), we suggest that all meningiomas should be evaluated for malignancy. The extent of surgical resection, the histological subtype, and the Ki-67 index can help to predict the clinical outcome for meningioma patients.
authors.affiliation: Department of Neurosurgery, Samsung Medical Center and Samsung Biomedical Research Institute, SungKyunKwan University School of Medicine, 50 Ilwon-Dong, Kangnam-ku, Seoul 135-710, Korea.
authors.forename: Kwang-Won
authors.initials: KW
authors.lastname: Ko
authors.forename: Do-Hyun
authors.initials: DH
authors.lastname: Nam
authors.forename: Doo-Sik
authors.initials: DS
authors.lastname: Kong
authors.forename: Jung-Ii
authors.initials: JI
authors.lastname: Lee
authors.forename: Kwan
authors.initials: K
authors.lastname: Park
authors.forename: Jong-Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000145:classification* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D019394:Ki-67 Antigen