title: Correspondence of tumor localization with tumor recurrence and cytogenetic progression in meningiomas.
abstract: OBJECTIVE
  Meningiomas are mostly benign tumors that originate from the coverings of the brain and spinal cord. Cytogenetically, they reveal a normal karyotype or, typically, monosomy of chromosome 22. Progression of meningiomas is associated with a non-random pattern of secondary losses of other autosomes. Deletion of the short arm of one chromosome 1 is a decisive step to anaplastic growth in meningiomas.
  
  
  METHODS
  Statistical analyses were performed for the karyotypes of 661 meningiomas with respect to localization, progression, and recurrence of the tumor. A mathematical mixture model estimates typical pathogenetic routes in terms of the accumulation of somatic chromosome changes in tumor cells. The model generates a genetic progression score (GPS) that estimates the prognosis as related to the cytogenetic properties of a given tumor.
  
  
  RESULTS
  In 53 patients, one or several recurrences were documented over the period of observation. This corresponds to a total rate of recurrence of 8.0% after macroscopically complete tumor extirpation. Higher GPS values were shown to be strongly correlated with tumor recurrence (P = 2.9 x 10(-7)). High-risk tumors, both in terms of histology and cytogenetics, are localized much more frequently at the brain surface than at the cranial base (P = 1.2 x 10(-5) for World Health Organization grade and P = 3.3 x 10(-12) for GPS categorization).
  
  
  CONCLUSIONS
  The tendency of cranial base meningiomas to recur seems to depend on surgical rather than biological reasons. As a quantitative measure, the GPS allows for a more precise assessment of the prognosis of meningiomas than the established categorical cytogenetic markers.
authors.affiliation: Department of Neurosurgery, Saarland University, Homburg/Saar, Germany. ncrket@uniklinik-saarland.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Ketter
authors.forename: Jörg
authors.initials: J
authors.lastname: Rahnenführer
authors.forename: Wolfram
authors.initials: W
authors.lastname: Henn
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Feiden
authors.forename: Wolf-Ingo
authors.initials: WI
authors.lastname: Steudel
authors.forename: Klaus D
authors.initials: KD
authors.lastname: Zang
authors.forename: Steffi
authors.initials: S
authors.lastname: Urbschat
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D003582:Cytogenetics; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007621:Karyotyping; D008297:Male; D008577:Meningeal Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology*; D008579:Meningioma / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology*; D008875:Middle Aged; D008962:Models, Theoretical; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies