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Histopathologic indicators of recurrence in meningiomas: correlation with clinical and genetic parameters

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Abstract

Meningiomas in general are circumscribed slow-growing tumors. However, despite gross total resection, tumor relapse and patients’ outcome are still an issue. Risk stratification based on histomorphology alone remains problematic. This study explored the independent prognostic value of potential risk factors among 206 patients who underwent meningioma resection and followed-up until death or a median of 44 months. The statistical analysis considered clinical data, histomorphologic parameters, cytogenetic findings, Ki-67 immunoreactivity, and activity of tissue non-specific alkaline phosphatase (ALPL). Recurrence-free survival estimates were computed and prognostic factors were identified using Cox proportional hazards model. Independent predictors of recurrence included (1) anaplasia; (2) mitotic index ≥20/10 high-power fields; (3) subtotal tumor resection; (4) loss of short arm of chromosome 1 (1p−); and (5) Ki-67 labeling index (LI) >12%. Among totally resected WHO grade I meningiomas, neither histopathologic nor clinical parameters were predictive, whereas 1p− was the only independent prognostic factor. ALPL did not reach significance in the multivariate modeling, however, the fast and low-cost histochemical detection of ALPL expression could be proved as a highly sensitive screening method for 1p−. In particular, biologically aggressive meningiomas of histologically benign or “borderline” phenotype could be therefore identified by ALPL detection followed by 1p in situ hybridization.

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Acknowledgement

The authors gratefully thank Mr. Craig Washington for the editorial help.

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Authors and Affiliations

  1. School of Medicine, Institute of Neuropathology, Saarland University, Bldg. 90.3, 66421, Homburg-Saar, Germany

    Yoo-Jin Kim & Wolfgang Feiden

  2. Department of Neurosurgery, School of Medicine, Saarland University, Homburg/Saar, Germany

    Ralf Ketter & Wolf-Ingo Steudel

  3. School of Medicine, Institute of Human Genetics, Saarland University, Homburg/Saar, Germany

    Wolfram Henn & Klaus D. Zang

Authors
  1. Yoo-Jin Kim
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  2. Ralf Ketter
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  3. Wolfram Henn
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  4. Klaus D. Zang
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  5. Wolf-Ingo Steudel
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  6. Wolfgang Feiden
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Correspondence to Yoo-Jin Kim.

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Kim, YJ., Ketter, R., Henn, W. et al. Histopathologic indicators of recurrence in meningiomas: correlation with clinical and genetic parameters. Virchows Arch 449, 529–538 (2006). https://doi.org/10.1007/s00428-006-0285-3

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  • DOI: https://doi.org/10.1007/s00428-006-0285-3

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