title: [Management of WHO grade II and II meningiomas: retrospective study of surgical series of 36 cases at a single institution].
abstract: BACKGROUND
  Atypical and malignant meningiomas are a rare disease whose histological definition is still recent. Their management is not consensual. The aim of this study was to review the outcome, prognostic factors and the role of complementary therapies.
  
  
  METHODS
  Between 1999 and 2007, 36 patients with atypical or malignant meningiomas were managed in our hospital. All surgical specimens were reviewed according to the 2007 WHO classification system. The sex ratio was 1.25 male, the median age was 59 years. The median follow-up was 55 months. Thirty meningiomas were atypical and six were malignant.
  
  
  RESULTS
  Five and 10 years overall survival rate are respectively 72 and 41%, whereas 5 and 10 years progression free survival rate are 61 and 23%. We only identify female sex, age over 70 years and Karnofsky status under 70% as negative prognostic factors.
  
  
  CONCLUSIONS
  Atypical and malignant meningiomas are difficult to manage and have high recurrence and poor survival rates. The prognostic of OMS II meningiomas is heterogeneous. Adjuvant radiation therapy is recommended in case of malignant menigioma or in case of atypical meningioma if incomplete surgical excision is performed.
authors.affiliation: Service de neurochirurgie, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France. jduntze@chu-reims.fr
authors.forename: J
authors.initials: J
authors.lastname: Duntze
authors.forename: P
authors.initials: P
authors.lastname: Metellus
authors.forename: C-F
authors.initials: CF
authors.lastname: Litre
authors.forename: C
authors.initials: C
authors.lastname: Eap
authors.forename: E
authors.initials: E
authors.lastname: Theret
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.forename: P
authors.initials: P
authors.lastname: Peruzzi
authors.forename: P
authors.initials: P
authors.lastname: Rousseaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014944:World Health Organization