title: World Health Organization grade III meningiomas. A retrospective study for outcome and prognostic factors assessment.
abstract: BACKGROUND
  Anaplastic meningiomas are uncommon primary intracranial tumours associated with high level of recurrence and low life expectancy. Through three institutions experience, we analysed the clinical characteristics of patients with malignant meningiomas to determine their outcome and identify prognostic factors that may influence recurrence and survival.
  
  
  METHODS
  A retrospective search identified 62 cases of WHO grade III meningiomas, of whom 9 (14.5%) were not considered in the survival analysis as no follow-up data were available. Thirty patients (48.4%) had a previous history of non-malignant meningioma surgery. The patients underwent a total of 139 surgical resections and 42 courses of radiotherapy of which 27 were given after the WHO grade III meningioma diagnosis.
  
  
  RESULTS
  Eighteen patients (29.5%) were re-operated for a relapse of their anaplastic meningioma. Median time between the first and the second surgery was 1.3 years. Median overall survival time was 3.5 years. Overall survival probabilities at 1, 2 and 5 years were 74.6%, 95% confidence interval (CI) [63.8, 87.1], 58.7%, 95% CI [46.4, 74.3] and 37.7%, 95% CI [25, 56.8], respectively. Extent of resection was associated with the survival.
  
  
  CONCLUSIONS
  This retrospective series highlights the poor prognosis associated with the diagnosis of malignant meningioma. Complete or subtotal resection may prolong the patients' survival. We could not confirm the usefulness of postoperative radiotherapy.
authors.affiliation: a Department of Neurosurgery , Institute of Neurological Sciences , Glasgow , UK.|d Department of Neurosurgery , National Hospital for Neurology and Neurosurgery , London , UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Champeaux
authors.affiliation: b Department of Clinical Oncology , University College London Hospitals NHS Foundation Trust , London , UK.
authors.forename: Elena
authors.initials: E
authors.lastname: Wilson
authors.affiliation: c Department of Neuropathology , National Hospital for Neurology and Neurosurgery , London , UK.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandner
authors.affiliation: d Department of Neurosurgery , National Hospital for Neurology and Neurosurgery , London , UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Shieff
authors.affiliation: d Department of Neurosurgery , National Hospital for Neurology and Neurosurgery , London , UK.
authors.forename: Lewis
authors.initials: L
authors.lastname: Thorne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: grade III meningioma; malignant meningioma; outcome; prognostic factors; radiotherapy