title: [Prognostic variability in atypical meningioma with complete resection. Proposed treatment algorithm].
abstract: OBJECTIVE
  The authors attempt to show how the current prognostic factors that try to assess the risk of recurrence of atypical meningiomas are insufficient to predict the future of this disease.
  
  
  METHODS
  Using data obtained from hospital databases, a sample of 27 patients was obtained with pathological diagnosis of atypical meningioma, and who had a minimum follow-up time of 6months after diagnosis. Later prognostic factors (age <50years, male gender, bone involvement, peri-lesional swelling, tumour volume, location, Ki67/MIB-1) were evaluated after the stratification of patients undergoing complete resection in recurrencies and non-recurrencies. Univariate analysis was performed using Mann-Whitney test, χ(2) homogeneity test/Fisher exact test. Finally, multivariate analysis was performed using binary logistic regression to obtain the values for R(2) Nagelkerke and the Hosmer-Lemeshow to evaluate the goodness of fit.
  
  
  RESULTS
  The uni- and multivariate analysis showed no statistically significant differences between recurrent and non-recurrent subgroups of patients undergoing complete resection. It is noted in the results that for each year of age above 50 years, the risk of recurrence is decreased by 5.8%.
  
  
  CONCLUSIONS
  Although current prognostic factors may show an increased risk of recurrence once patients are stratified by the two most important factors (pathology and extent of resection), those factors are insufficient to predict the ultimate outcome of patients affected by this pathology.
authors.affiliation: Servicio de Neurocirugía, Hospital Clínico Universitario de Valencia, Valencia, España. Electronic address: luisreal85@gmail.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Real-Peña
authors.affiliation: Servicio de Neurocirugía, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Talamantes Escribá
authors.affiliation: Servicio de Neurocirugía, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: Vicent
authors.initials: V
authors.lastname: Quilis-Quesada
authors.affiliation: Servicio de Neurocirugía, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: González-Darder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001932:Brain Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D011379:Prognosis
keywords: Afectación ósea; Atypical meningioma; Bone involvement; Complete resection; Edema perilesional; Ki67; Localización tumoral; Meningioma atípico; Perilesional oedema; Resección completa; Tumour location