Malignant potential of skull base versus non-skull base meningiomas: clinical series of 1,663 cases
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About 90 % of meningiomas are benign (WHO grade I), atypical and anaplastic variants exist (WHO grade II/III, 10 %). Tumour grade has important implications for management. Non-invasive diagnosis of tumour grade is still not feasible. The purpose of this survey was to analyse epidemiological risk factors such as sex, age and location for a higher grade (WHO grade II/III) meningioma in a large surgical series.
A retrospective study comprising 1,663 patients operated on for an intracranial meningioma in a single tertiary-care centre. The population was analysed for correlations including WHO grade, histological subtype, tumour localisation, patient age and gender. Additionally correlations between Ki67 index/WHO grade and localisation were analysed.
A binary logistic regression analysis revealed non-skull base localisation (OR 1.779 [CI 1.069–2.960, p = 0.0027]) and age ≥65 years (OR 1.549 [CI 1.214–2.624, p = 0.012]) as significant risk factors for a higher WHO grade. Male gender showed a trend for a higher risk in χ2 analysis. An analysis of the Ki67 index revealed an increased index for non-skull base localisation compared with skull base (p < 0.001). Correlation analysis of Ki67 distribution in WHO grade I meningiomas revealed higher Ki67 indices for non skull base localisation (p = 0.0024).
Non-skull base localisation and age ≥65 years are independent risk factors for higher grade meningiomas. In other terms, the malignant potential of skull base meningiomas is low. This information is important when advising a patient about individual treatment options (observation, surgery or radio-surgery) and prognosis.
KeywordsLocalisation Meningioma Risk factor Skull base WHO grade
We would like to thank the Neurosurgical Department of Rothschild Hospital, Paris for providing tumour material to the Neuropathology Department of Lariboisiere Hospital. We would like to thank Tadeusz Dobrowolski and Alice Jousselin for help in proofreading.
Conflicts of interest
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