Clinical Implications of the Mitotic Index As a Predictive Factor for Malignant Transformation of Atypical Meningiomas

Overview

Journal J Korean Neurosurg Soc

Date 2021 Dec 9

PMID 34879641

Citations 2

Authors

Sae Min Kwon

Jeong Hoon Kim

Young-Hoon Kim

Seok Ho Hong

Young Hyun Cho

Chang Jin Kim

Soo Jeong Nam

Affiliations

Soon will be listed here.

Abstract

Objective: Intracranial atypical meningiomas have a poor prognosis and high rates of recurrence. Moreover, up to one-third of the recurrences undergo high-grade transformation into malignant meningiomas. We aimed to investigate the clinical factors that can predict the propensity of malignant transformation from atypical to anaplastic meningiomas.

Methods: Between 2001 and 2018, all patients with atypical meningioma, in whom the tumors had undergone malignant transformation to anaplastic meningioma, were included. The patients' medical records documenting the diagnosis of atypical meningioma prior to malignant transformation were reviewed to identify the predictors of transformation. The control group comprised 56 patients with atypical meningiomas who were first diagnosed between January 2017 and December 2018 and had no malignant transformation.

Results: Nine patients in whom the atypical meningiomas underwent malignant transformation were included. The median time interval from diagnosis of atypical meningioma to malignant transformation was 19 months (range, 7-78). The study group showed a significant difference in heterogeneous enhancement (77.8% vs. 33.9%), bone invasion (55.6% vs. 12.5%), mitotic index (MI; 14.8±4.9 vs. 3.5±3.9), and Ki-67 index (20.7±13.9 vs. 9.5±7.1) compared with the control group. In multivariate analysis, increased MI (odds ratio, 1.436; 95% confidence interval, 1.127-1.900; p=0.004) was the only significant factor for predicting malignant transformation.

Conclusion: An increased MI within atypical meningiomas might be used as a predictor of malignant transformation. Tumors at high risk for malignant transformation might require more attentive surveillance and management than other atypical meningiomas.

Citing Articles

Malignant Transformation of Meningiomas.

Yu J, Deng J, Ren L, Hua L, Gong Y J Cancer. 2025; 16(5):1684-1693.

PMID: 39991581 PMC: 11843249. DOI: 10.7150/jca.105024.

The Impact of Molecular and Genetic Analysis on the Treatment of Patients with Atypical Meningiomas.

Ravnik J, Rowbottom H Diagnostics (Basel). 2024; 14(16).

PMID: 39202270 PMC: 11353905. DOI: 10.3390/diagnostics14161782.

Atypical meningioma: Histopathological, genetic, and epigenetic features to predict recurrence risk.

Marastoni E, Barresi V Histol Histopathol. 2023; 39(3):293-302.

PMID: 37921468 DOI: 10.14670/HH-18-670.

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