title: Does Histologic Subtype Influence the Post-Operative Outcome in Spinal Meningioma?
abstract: BACKGROUND
  Postoperative outcome of spinal meningiomas is an important issue in surgery decision-making. There are limited and conflicting data in the literature about the prognostic factors influencing recovery, especially about the histopathologic subtypes.
  
  
  OBJECTIVE
  This study was carried out to evaluate the effect of some of these factors on postoperative outcome.
  
  
  METHODS
  This study was performed on 39 patients operated for spinal meningioma between October 1998 and January 2012; their histopathologic subtype was determined according to WHO criteria. The follow up period ranged between 8 - 120 months. The influence of histopathologic subtype, grade, age, sex, surgical approach, local adhesion and anatomical location was assessed according to Frankel classification of neurologic deficit.
  
  
  RESULTS
  From a total number of 39 spinal meningiomas, 34 cases were WHO grade I, from which 15 cases were psammomatous, 7 cases were meningothelial, 9 cases were transitional and 3 cases were fibroblastic. Five cases were grade II, 3 of which had clear cell appearance and the remaining 2 had chordoid appearance. The mean age was 51.6 (22 to 76) years; 25 cases were female and 14 cases were male. This study revealed that grade II meningioma cases had poor prognosis in all 5 cases and psammomatous subtype had poor postoperative outcome in 40% of cases while the other subtypes had good outcome in all cases (P = 0.026). Cervical location of the tumor was also related with poor outcome in 37.5% of the cases, while 22.5% had poor outcome in other locations (P = 0.029). Age below and above 45 years and sex had no significant influence on the outcome.
  
  
  CONCLUSIONS
  Spinal meningiomas of psammomatous type and grade II spinal meningiomas are associated with less favorable postoperative neurologic outcome. Cervical location has also a negative correlation with a good outcome.
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hanieh
authors.initials: H
authors.lastname: Zham
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Rakhshan
authors.affiliation: Research Center for Neurosurgery and Functional Nerves, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Zali
authors.affiliation: Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Rahbari
authors.affiliation: Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Raee
authors.affiliation: Research Center for Neurosurgery and Functional Nerves, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Ashrafi
authors.affiliation: Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mahsa
authors.initials: M
authors.lastname: Ahadi
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Larijani
authors.affiliation: Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Baikpour
authors.affiliation: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Khayamzadeh
keywords: Meningioma; Pathology; Spinal Cord Neoplasms; Treatment Outcome