Brain Invasion in Meningioma-A Prognostic Potential Worth Exploring

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2021 Jul 2

PMID 34209798

Citations 17

Authors

Felix Behling

Johann-Martin Hempel

Jens Schittenhelm

Affiliations

Soon will be listed here.

Abstract

Most meningiomas are slow growing tumors arising from the arachnoid cap cells and can be cured by surgical resection or radiation therapy in selected cases. However, recurrent and aggressive cases are also quite common and challenging to treat due to no established treatment alternatives. Assessment of the risk of recurrence is therefore of utmost importance and several prognostic clinical and molecular markers have been established. Additionally, the identification of invasive growth of meningioma cells into CNS tissue was demonstrated to lead to a higher risk of recurrence and was therefore integrated into the WHO classification of CNS tumors. However, the evidence for its prognostic impact has been questioned in subsequent studies and its exclusion from the next WHO classification proposed. We were recently able to show the prognostic impact of CNS invasion in a large comprehensive retrospective meningioma cohort including other established prognostic factors. In this review we discuss the growing experiences that have been gained on this matter, with a focus on the currently nonuniform histopathological assessment, imaging characteristics and intraoperative sampling as well as the overall outlook on the future role of this potential prognostic factor.

Citing Articles

Impact of 2021 World Health Organization Grading, Peritumoral Edema, and Radiotherapy on the Recurrence of a Grossly Resected Intracranial Meningiomas: A Ten-Year Follow-Up Study.

Alkhotani A, Baeesa S, Alshanqiti M, Alsinani T, Najjar A, Alkhayyat S World J Oncol. 2025; 16(1):95-103.

PMID: 39850529 PMC: 11750757. DOI: 10.14740/wjon1999.

Emergency Surgical Management of Meningiomas: Factors Affecting Early Outcomes and Complications.

Tyagi G, Chandshah M, Birua G, Sadashiva N, Konar S, Beniwal M Asian J Neurosurg. 2024; 19(4):715-720.

PMID: 39606310 PMC: 11588614. DOI: 10.1055/s-0044-1790514.

Preoperative prediction of CNS WHO grade and tumour aggressiveness in intracranial meningioma based on radiomics and structured semantics.

Kalasauskas D, Kosterhon M, Kurz E, Schmidt L, Altmann S, Grauhan N Sci Rep. 2024; 14(1):20586.

PMID: 39232068 PMC: 11374997. DOI: 10.1038/s41598-024-71200-0.

Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients.

Wang J, Landry A, Raleigh D, Sahm F, Walsh K, Goldbrunner R Neuro Oncol. 2024; 26(10):1742-1780.

PMID: 38695575 PMC: 11449035. DOI: 10.1093/neuonc/noae082.

Simpson's Grading Scale for WHO Grade I Meningioma Resection in the Modern Neurosurgical Era: Are We Really Asking the Right Question?.

Dadario N, Sughrue M J Neurol Surg B Skull Base. 2024; 85(2):145-155.

PMID: 38449587 PMC: 10914467. DOI: 10.1055/a-2021-8852.

References

Li D, Jiang P, Xu S, Li C, Xi S, Zhang J . Survival impacts of extent of resection and adjuvant radiotherapy for the modern management of high-grade meningiomas. J Neurooncol. 2019; 145(1):125-134. PMC: 6775537. DOI: 10.1007/s11060-019-03278-w. View

Borghei-Razavi H, Truong H, Fernandes-Cabral D, Celtikci E, Chabot J, Stefko S . Minimally Invasive Approaches for Anterior Skull Base Meningiomas: Supraorbital Eyebrow, Endoscopic Endonasal, or a Combination of Both? Anatomic Study, Limitations, and Surgical Application. World Neurosurg. 2018; 112:e666-e674. DOI: 10.1016/j.wneu.2018.01.119. View

Biczok A, Karschnia P, Vitalini R, Lenski M, Greve T, Thorsteinsdottir J . Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I. Acta Neurochir (Wien). 2021; 163(10):2853-2859. PMC: 8437882. DOI: 10.1007/s00701-021-04780-9. View

Fioravanzo A, Caffo M, Di Bonaventura R, Gardiman M, Ghimenton C, Ius T . A Risk Score Based on 5 Clinico-Pathological Variables Predicts Recurrence of Atypical Meningiomas. J Neuropathol Exp Neurol. 2020; 79(5):500-507. DOI: 10.1093/jnen/nlaa018. View

Banan R, Abbetmeier-Basse M, Hong B, Dumitru C, Sahm F, Nakamura M . The prognostic significance of clinicopathological features in meningiomas: Microscopic brain invasion can predict patient outcome in otherwise benign meningiomas. Neuropathol Appl Neurobiol. 2021; 47(6):724-735. DOI: 10.1111/nan.12700. View

Vranic A, Popovic M, Cor A, Prestor B, Pizem J . Mitotic count, brain invasion, and location are independent predictors of recurrence-free survival in primary atypical and malignant meningiomas: a study of 86 patients. Neurosurgery. 2010; 67(4):1124-32. DOI: 10.1227/NEU.0b013e3181eb95b7. View

Spasic M, Pelargos P, Barnette N, Bhatt N, Lee S, Ung N . Incidental Meningiomas: Management in the Neuroimaging Era. Neurosurg Clin N Am. 2016; 27(2):229-38. DOI: 10.1016/j.nec.2015.11.012. View

Zeltner L, Schittenhelm J, Mittelbronn M, Roser F, Tatagiba M, Mawrin C . The astrocytic response towards invasive meningiomas. Neuropathol Appl Neurobiol. 2007; 33(2):163-8. DOI: 10.1111/j.1365-2990.2006.00792.x. View

Zhang J, Sun J, Han T, Zhao Z, Cao Y, Zhang G . Radiomic features of magnetic resonance images as novel preoperative predictive factors of bone invasion in meningiomas. Eur J Radiol. 2020; 132:109287. DOI: 10.1016/j.ejrad.2020.109287. View

10.

Rogers C, Perry A, Pugh S, Vogelbaum M, Brachman D, McMillan W . Pathology concordance levels for meningioma classification and grading in NRG Oncology RTOG Trial 0539. Neuro Oncol. 2015; 18(4):565-74. PMC: 4799683. DOI: 10.1093/neuonc/nov247. View

11.

Goldbrunner R, Minniti G, Preusser M, Jenkinson M, Sallabanda K, Houdart E . EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol. 2016; 17(9):e383-91. DOI: 10.1016/S1470-2045(16)30321-7. View

12.

Sahm F, Schrimpf D, Olar A, Koelsche C, Reuss D, Bissel J . TERT Promoter Mutations and Risk of Recurrence in Meningioma. J Natl Cancer Inst. 2015; 108(5). PMC: 4849806. DOI: 10.1093/jnci/djv377. View

13.

Katz L, Hielscher T, Liechty B, Silverman J, Zagzag D, Sen R . Loss of histone H3K27me3 identifies a subset of meningiomas with increased risk of recurrence. Acta Neuropathol. 2018; 135(6):955-963. DOI: 10.1007/s00401-018-1844-9. View

14.

Behling F, Fodi C, Gepfner-Tuma I, Machetanz K, Renovanz M, Skardelly M . CNS Invasion in Meningioma-How the Intraoperative Assessment Can Improve the Prognostic Evaluation of Tumor Recurrence. Cancers (Basel). 2020; 12(12). PMC: 7761660. DOI: 10.3390/cancers12123620. View

15.

Brunner E, Romeike B, Jung M, Comtesse N, Meese E . Altered expression of beta-catenin/E-cadherin in meningiomas. Histopathology. 2006; 49(2):178-87. DOI: 10.1111/j.1365-2559.2006.02440.x. View

16.

Champeaux C, Wilson E, Shieff C, Khan A, Thorne L . WHO grade II meningioma: a retrospective study for outcome and prognostic factor assessment. J Neurooncol. 2016; 129(2):337-45. DOI: 10.1007/s11060-016-2181-2. View

17.

Ostrom Q, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan J . CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013-2017. Neuro Oncol. 2020; 22(12 Suppl 2):iv1-iv96. PMC: 7596247. DOI: 10.1093/neuonc/noaa200. View

18.

Clark V, Erson-Omay E, Serin A, Yin J, Cotney J, Ozduman K . Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science. 2013; 339(6123):1077-80. PMC: 4808587. DOI: 10.1126/science.1233009. View

19.

Louis D, Ohgaki H, Wiestler O, Cavenee W, Burger P, Jouvet A . The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007; 114(2):97-109. PMC: 1929165. DOI: 10.1007/s00401-007-0243-4. View

20.

Nakasu S, Nakasu Y . Prognostic significance of brain invasion in meningiomas: systematic review and meta-analysis. Brain Tumor Pathol. 2021; 38(2):81-95. DOI: 10.1007/s10014-020-00390-y. View