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Male sex and presence of preoperative symptoms are associated with early recurrence of WHO grade I meningiomas after surgical resection: analysis from the nationwide Brain Tumor Registry of Japan

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Abstract

This study aimed to assess the risk factors for the recurrence of WHO grade I intracranial meningiomas using the Brain Tumor Registry of Japan (BTRJ) database. We extracted the data of 4641 patients with intracranial WHO grade I meningiomas treated only by surgical resection between 2001 and 2008. We conducted complete data analysis (n = 3690) and multiple imputation analysis (n = 4641) to adjust for missing data on tumor size. The influence of factors including age, sex, size, extent of resection, location, and preoperative symptoms on PFS was assessed. Univariate analyses of the complete data set showed that age did not affect PFS; however, male sex (p < 0.001), tumor size ≥ 30 mm (p < 0.001), low extent of resection, tumor location at the skull base (p < 0.001), and the presence of preoperative symptoms (p < 0.001) were risk factors for a significantly shorter PFS. Multivariate analysis demonstrated that male sex (p < 0.001) and presence of preoperative symptoms (p = 0.027) were independent risk factors for shorter PFS alongside large tumor size (p < 0.001) and non-gross total resection (p < 0.001). These results were confirmed for the imputed dataset. While most previous large nationwide studies of meningiomas have evaluated overall survival, progression-free survival has yet to be thoroughly examined. This study suggests that even histologically benign meningiomas may have a sex difference in postoperative behavior. This observation may provide clues to understanding the mechanism of meningioma cell proliferation.

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Data availability

The de-identified participant data presented in this study are available upon request from a qualified investigator to replicate the results.

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Acknowledgements

The authors thank all members of the Japan Neurosurgical Society for their cooperation in regularly registering their data and keeping the BTRJ up to date.

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Authors and Affiliations

  1. Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan

    Soichi Oya

  2. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Fusao Ikawa

  3. Department of Healthcare Quality Assessment, The University of Tokyo, Tokyo, Japan

    Nao Ichihara

  4. Department of Neurosurgery, Sapporo Medical University, Hokkaido, Japan

    Masahiko Wanibuchi, Yukinori Akiyama & Nobuhiro Mikuni

  5. Department of Neurosurgery, The University of Tokyo, Tokyo, Japan

    Hirofumi Nakatomi

  6. Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan

    Yoshitaka Narita

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  1. Soichi Oya
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Contributions

Conception and design: SO. Acquisition of data: SO and FI. Data analysis and interpretation: SO, FI, and NI. Drafting of the article: SO. Critical revision of the article: all authors. Reviewed submitted version of the manuscript: all authors. All the authors approved the final version of the manuscript. Statistical analysis: SO and NI. Administrative technical/material support: MW, YA, HN, and NM. Study supervision: YN.

Corresponding author

Correspondence to Soichi Oya.

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Ethical approval and consent to participate

This study was approved by the institutional review board of Saitama Medical Center, Saitama Medical University (No. 1527-IV), and by the Japan Neurosurgical Society (No. 2019007). The requirement for written informed consent from patients was waived by the above-mentioned boards owing to the use of retrospective anonymized data.

Consent for publication

The requirement for written informed consent from patients for publication was waived owing to the use of retrospective anonymous data. Patients were given the opportunity to opt out of the study on our hospital website.

Human and animal ethics

All reported analyses involving human participants in this study were performed in accordance with the ethical standards established in the 1964 Declaration of Helsinki and its later amendments.

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The authors declare no competing interests.

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Oya, S., Ikawa, F., Ichihara, N. et al. Male sex and presence of preoperative symptoms are associated with early recurrence of WHO grade I meningiomas after surgical resection: analysis from the nationwide Brain Tumor Registry of Japan. Neurosurg Rev 46, 10 (2023). https://doi.org/10.1007/s10143-022-01907-z

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