Advertisement

Journal of Neuro-Oncology

, Volume 140, Issue 3, pp 639–647 | Cite as

Clinical and prognostic features of spinal meningioma: a thorough analysis from a single neurosurgical center

  • Lingyang Hua
  • Hongda Zhu
  • Jiaojiao Deng
  • Mi Tian
  • Xuewei Jiang
  • Hailiang Tang
  • Shihai Luan
  • Hiroaki Wakimoto
  • Qing Xie
  • Ye Gong
Clinical Study

Abstract

Purpose

The aim of this study was to thoroughly analyze the clinical characteristics of a large cohort of spinal meningioma (SM) from a single neurological center and identify risk factors associated with worse progression free survival and neurological function outcome.

Methods

Clinical information was retrieved from 483 SM and 9806 cranial meningioma cases who were operated in our center between 2003 and 2013. 194 SM patients who were followed at the main branch were used for prognostic analyses that included both recurrence free survival and neurological functions based on Modified McCormick scale (MMS).

Results

Females were predominant (P < 0.001). High grade tumors were not common (WHO grade II, 2.9%; grade III, 1.7%), while the clear cell subtype was frequent within grade II SMs (6/14, 42.9%). Macroscopic total resection was achieved in all SMs (Simpson grade I, 30.9%; grade II, 65.5%; grade III, 3.6%) with a low complications rate (4.6%) and provided neurological improvement in 80 patients (41.2%). Recurrence was seen in 9 cases (4.6%) and associated with high WHO grade, male, prior recurrence, and Simpson grade III. High WHO grade and high Ki-67 index were identified to be independent factors predictive of both neurological function deterioration and impaired post-operative neurological status.

Conclusions

Our analysis of the largest SM cohort in scale from a single institution offers a comprehensive view of the clinical characteristics of surgically treated SM, revealing the distinct biology of SM in comparison to its cranial counterparts, and providing guidance to improve surgical management of SM.

Keywords

Spinal meningioma Epidemiology Neurological function Prognosis Recurrence 

Abbreviations

SM

Spinal meningioma

MMS

Modified McCormick scale

T1WI

T1 Weighted image

MRI

Magnetic resonance imaging

PR

Progesterone receptor

PFS

Progression free survival

SEP

Somatosensory evoked potentials

MEP

Motor evoked potentials

Notes

Funding

The work has not been submitted elsewhere for publication, in whole or in part. This study was supported by grants from the National Natural Science Foundation of China (81772674 to Y. Gong) and the Science and Technology Commission of Shanghai Municipality (18140900200 and 16140903000 to Y. Gong).

Compliance with ethical standards

Disclosures

The authors had no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Supplementary material

11060_2018_2993_MOESM1_ESM.tif (99.3 mb)
Supplementary Fig 1. Sagittal location of SM in the initial cohort. (TIF 101632 KB)
11060_2018_2993_MOESM2_ESM.tif (34.7 mb)
Supplementary Fig 2. Pathological distribution of SM based on gender in the initial cohort. (TIF 35582 KB)

References

  1. 1.
    Bret P, Lecuire J, Lapras C, Deruty R, Dechaume JP, Assaad A (1976) Intraspinal meningiomas. A series of 60 cases. Neurochirurgie 22:5–22Google Scholar
  2. 2.
    Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, Ajani UA (2012) Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004–2007. Cancer 118:4220–4227.  https://doi.org/10.1002/cncr.27390 CrossRefGoogle Scholar
  3. 3.
    Helseth A, Mork SJ (1989) Primary intraspinal neoplasms in Norway, 1955 to 1986. A population-based survey of 467 patients. J Neurosurg 71:842–845.  https://doi.org/10.3171/jns.1989.71.6.0842 CrossRefGoogle Scholar
  4. 4.
    Kshettry VR, Hsieh JK, Ostrom QT, Kruchko C, Benzel EC, Barnholtz-Sloan JS (2015) Descriptive epidemiology of spinal meningiomas in the United States. Spine 40:E886–E889.  https://doi.org/10.1097/brs.0000000000000974 CrossRefGoogle Scholar
  5. 5.
    Solero CL, Fornari M, Giombini S, Lasio G, Oliveri G, Cimino C, Pluchino F (1989) Spinal meningiomas: review of 174 operated cases. Neurosurgery 25:153–160CrossRefGoogle Scholar
  6. 6.
    Westwick HJ, Shamji MF (2015) Effects of sex on the incidence and prognosis of spinal meningiomas: a surveillance, epidemiology, and end results study. J Neurosurg Spine 23:368–373.  https://doi.org/10.3171/2014.12.spine14974 CrossRefGoogle Scholar
  7. 7.
    Maiuri F, De Caro ML, de Divitiis O, Vergara P, Mariniello G (2011) Spinal meningiomas: age-related features. Clin Neurol Neurosurg 113:34–38.  https://doi.org/10.1016/j.clineuro.2010.08.017 CrossRefGoogle Scholar
  8. 8.
    Raco A, Pesce A, Toccaceli G, Domenicucci M, Miscusi M, Delfini R (2017) Factors leading to a poor functional outcome in spinal meningioma surgery: remarks on 173 cases. Neurosurgery 80:602–609.  https://doi.org/10.1093/neuros/nyw092 CrossRefGoogle Scholar
  9. 9.
    Kim CH, Chung CK, Lee SH, Jahng TA, Hyun SJ, Kim KJ, Yoon SH, Kim ES, Eoh W, Kim HJ, Kim KT, Sung JK, Choi Y (2016) Long-term recurrence rates after the removal of spinal meningiomas in relation to Simpson grades. Eur Spine J 25:4025–4032.  https://doi.org/10.1007/s00586-015-4306-2 CrossRefGoogle Scholar
  10. 10.
    Klekamp J, Samii M (1999) Surgical results for spinal meningiomas. Surg Neurol 52:552–562CrossRefGoogle Scholar
  11. 11.
    Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL (1985) Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62:18–24.  https://doi.org/10.3171/jns.1985.62.1.0018 CrossRefGoogle Scholar
  12. 12.
    McCormick PC, Stein BM (1990) Intramedullary tumors in adults. Neurosurg Clin N Am 1:609–630CrossRefGoogle Scholar
  13. 13.
    Gottfried ON, Gluf W, Quinones-Hinojosa A, Kan P, Schmidt MH (2003) Spinal meningiomas: surgical management and outcome. Neurosurg Focus 14:e2Google Scholar
  14. 14.
    Roux FX, Nataf F, Pinaudeau M, Borne G, Devaux B, Meder JF (1996) Intraspinal meningiomas: review of 54 cases with discussion of poor prognosis factors and modern therapeutic management. Surg Neurol 46:458–463 (discussion 463-454)CrossRefGoogle Scholar
  15. 15.
    Setzer M, Vatter H, Marquardt G, Seifert V, Vrionis FD (2007) Management of spinal meningiomas: surgical results and a review of the literature. Neurosurg Focus 23:E14.  https://doi.org/10.3171/foc-07/10/e14 CrossRefGoogle Scholar
  16. 16.
    Sade B, Chahlavi A, Krishnaney A, Nagel S, Choi E, Lee JH (2007) World Health Organization Grades II and III meningiomas are rare in the cranial base and spine. Neurosurgery 61:1194–1198.  https://doi.org/10.1227/01.neu.0000306097.38141.65 (discussion 1198)CrossRefGoogle Scholar
  17. 17.
    Bayoumi AB, Laviv Y, Karaali CN, Ertilav K, Kepoglu U, Toktas ZO, Konya D, Kasper EM (2017) Spinal meningiomas: 61 cases with predictors of early postoperative surgical outcomes. J Neurosurg Sci.  https://doi.org/10.23736/s0390-5616.17.04102-9 Google Scholar
  18. 18.
    Gezen F, Kahraman S, Canakci Z, Beduk A (2000) Review of 36 cases of spinal cord meningioma. Spine 25:727–731CrossRefGoogle Scholar
  19. 19.
    King AT, Sharr MM, Gullan RW, Bartlett JR (1998) Spinal meningiomas: a 20-year review. Br J Neurosurg 12:521–526CrossRefGoogle Scholar
  20. 20.
    Sun SQ, Cai C, Ravindra VM, Gamble P, Yarbrough CK, Dacey RG, Dowling JL, Zipfel GJ, Wright NM, Santiago P, Robinson CG, Schmidt MH, Kim AH, Ray WZ (2015) Simpson grade I-III resection of spinal atypical (World Health Organization Grade II) meningiomas is associated with symptom resolution and low recurrence. Neurosurgery 76:739–746.  https://doi.org/10.1227/neu.0000000000000720 CrossRefGoogle Scholar
  21. 21.
    Westwick HJ, Yuh SJ, Shamji MF (2015) Complication avoidance in the resection of spinal meningiomas. World Neurosurg 83:627–634.  https://doi.org/10.1016/j.wneu.2014.12.015 CrossRefGoogle Scholar
  22. 22.
    Hua L, Zhu H, Li J, Tang H, Kuang D, Wang Y, Tang F, Chen X, Zhou L, Xie Q, Gong Y (2018) Prognostic value of estrogen receptor in WHO Grade III meningioma: a long-term follow-up study from a single institution. J Neurosurg 128:1698–1706.  https://doi.org/10.3171/2017.2.jns162566 CrossRefGoogle Scholar
  23. 23.
    Nakamura M, Tsuji O, Fujiyoshi K, Hosogane N, Watanabe K, Tsuji T, Ishii K, Toyama Y, Chiba K, Matsumoto M (2012) Long-term surgical outcomes of spinal meningiomas. Spine 37:E617–E623.  https://doi.org/10.1097/BRS.0b013e31824167f1 CrossRefGoogle Scholar
  24. 24.
    Sandalcioglu IE, Hunold A, Muller O, Bassiouni H, Stolke D, Asgari S (2008) Spinal meningiomas: critical review of 131 surgically treated patients. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical. Spine Res Soc 17:1035–1041.  https://doi.org/10.1007/s00586-008-0685-y Google Scholar
  25. 25.
    Levy WJ Jr, Bay J, Dohn D (1982) Spinal cord meningioma. J Neurosurg 57:804–812.  https://doi.org/10.3171/jns.1982.57.6.0804 CrossRefGoogle Scholar
  26. 26.
    Ciappetta P, Domenicucci M, Raco A (1988) Spinal meningiomas: prognosis and recovery factors in 22 cases with severe motor deficits. Acta Neurol Scand 77:27–30CrossRefGoogle Scholar
  27. 27.
    Cohen-Gadol AA, Zikel OM, Koch CA, Scheithauer BW, Krauss WE (2003) Spinal meningiomas in patients younger than 50 years of age: a 21-year experience. J Neurosurg 98:258–263Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
  2. 2.Department of Critical Medicine, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
  3. 3.Department of Neurosurgery, Massachusetts General HospitalHarvard Medical SchoolBostonUSA

Personalised recommendations