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Clear cell histology portends a worse prognosis than other WHO grade II histologies

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Abstract

Purpose

Clear cell meningioma (CCM) is a rare WHO grade II meningioma variant, characterized by aggressive features and a high tumor recurrence rate. In this study, we compared overall and progression-free survivals between CCMs and other WHO grade II meningiomas.

Methods

A retrospective institutional database review was performed to identify all patients who underwent surgical resection of a WHO grade II meningioma between 1997 and 2019. Overall survival and progression-free survival were compared between patients with clear cell meningiomas and patients with other WHO grade II meningiomas. Multivariable Cox proportional-hazards analysis was used to identify independent predictors of tumor recurrence and survival.

Results

We included a total of 214 patients in this study (43 CCMs, 171 other WHO grade II meningiomas). Patients with CCMs had significantly shorter progression-free (p = 0.001) and overall (p = 0.026) survivals than patients with other grade II meningiomas. In multivariable analysis, clear cell histology was a significant and powerful independent predictor of tumor recurrence (HR 1.93; 95% CI 1.14–3.26) when controlling for tumor location, extent of resection, and adjuvant radiation. In multivariable analysis, clear cell histology correlated with increased mortality (HR 1.96, 95% CI 0.97–3.94), though this was not statistically significant.

Conclusion

This is the first study to compare overall and progression-free survivals between CCMs and other WHO grade II meningiomas. Clear cell histology predicts a higher risk of tumor recurrence and mortality than other grade II histologies. Future studies may help to understand the impact of these findings and the treatment implications.

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Data availability

De-identified raw data available upon request.

Code availability

Available upon request.

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Authors and Affiliations

  1. Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

    Pranay Soni, Jianning Shao, Arbaz Momin, Diana Lopez, Lilyana Angelov, Alireza M. Mohammadi, Gene H. Barnett, Pablo F. Recinos & Varun R. Kshettry

  2. Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Pranay Soni, Lilyana Angelov, Alireza M. Mohammadi, Gene H. Barnett, Pablo F. Recinos & Varun R. Kshettry

  3. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    Jianning Shao, Arbaz Momin, Diana Lopez, Lilyana Angelov, Alireza M. Mohammadi, Gene H. Barnett, Pablo F. Recinos & Varun R. Kshettry

  4. Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, 9500 Euclid Avenue, CA5-86, Cleveland, OH, 44195, USA

    Varun R. Kshettry

Authors
  1. Pranay Soni
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  2. Jianning Shao
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  9. Varun R. Kshettry
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Correspondence to Varun R. Kshettry.

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Conflict of interest

Gene H. Barnett (consultant, Monteris Medical, Inc.), Pablo F. Recinos (consultant, Stryker), Varun R. Kshettry (consultant, Integra and Stryker).

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Soni, P., Shao, J., Momin, A. et al. Clear cell histology portends a worse prognosis than other WHO grade II histologies. J Neurooncol 151, 307–312 (2021). https://doi.org/10.1007/s11060-020-03668-5

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  • DOI: https://doi.org/10.1007/s11060-020-03668-5

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