title: Recent advances in the management of atypical meningiomas.
abstract: Based on the 2007 WHO classification, the proportion of atypical meningiomas has steeply increased. Complete resection is usually considered curative, however, the recurrence rate remains high. The treatment of more aggressive meningiomas remains problematic. We performed a literature review via the PubMed database with specific attention to radiological, pathological, genetic and molecular aspects particular to WHO grade II meningiomas and current therapeutic strategies. We also reviewed the role of surgery and summarized the results of the principal studies dealing with adjuvant strategies based on the most recent evidence. Adjuvant radiotherapy, administered as stereotactic radiosurgery or conventional external beam irradiation, should be strongly considered in selected cases. Limited data exist regarding the role of hormonal treatment or chemotherapy as adjunct therapy. A target therapy modulating the altered molecular balance may be the key to revolutionize the prognosis of these patients.
authors.affiliation: Department of neurosurgery, faculty of medicine - Paris Sud, Kremlin-Bicêtre university hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France. Electronic address: mahmoud.messerer@chuv.ch.
authors.forename: M
authors.initials: M
authors.lastname: Messerer
authors.affiliation: Department of clinical neurosciences, service of neurosurgery, faculty of medicine and biology of Lausanne, Lausanne university hospital, 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Richoz
authors.affiliation: Department of clinical neurosciences, service of neurosurgery, faculty of medicine and biology of Lausanne, Lausanne university hospital, 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Cossu
authors.affiliation: Department of radiation oncology, institut Gustave-Roussy university hospital, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
authors.forename: F
authors.initials: F
authors.lastname: Dhermain
authors.affiliation: Neuro-oncology unit, department of clinical neurosciences & oncology, Lausanne university hospital, faculty of medicine and biology of Lausanne, 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: A F
authors.initials: AF
authors.lastname: Hottinger
authors.affiliation: Department of neurosurgery, faculty of medicine - Paris Sud, Kremlin-Bicêtre university hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
authors.forename: F
authors.initials: F
authors.lastname: Parker
authors.affiliation: Department of clinical neurosciences, service of neurosurgery, faculty of medicine and biology of Lausanne, Lausanne university hospital, 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Levivier
authors.affiliation: Department of clinical neurosciences, service of neurosurgery, faculty of medicine and biology of Lausanne, Lausanne university hospital, 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: R T
authors.initials: RT
authors.lastname: Daniel
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D016634:Radiosurgery / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Adjuvant radiotherapy; Atypical meningioma; Conventional external beam radiotherapy; Genetics; Management; Molecular biology; Radiology; Stereotactic radiosurgery; Surgery; WHO grade II meningioma