Meningioma natural history: Difference between revisions
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* The 5 year estimated survival for benign tumors is 85.6%, 82.3% for borderline malignant tumors, and 66% for malignant tumors. A poorer survival rate may be seen in patients of advanced age, male patients, black race, malignant tumors, and patients with no initial treatment.<ref name="pmid25872752">{{cite journal| author=Dolecek TA, Dressler EV, Thakkar JP, Liu M, Al-Qaisi A, Villano JL| title=Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act. | journal=Cancer | year= 2015 | volume= 121 | issue= 14 | pages= 2400-10 | pmid=25872752 | doi=10.1002/cncr.29379 | pmc=5549267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25872752 }} </ref> | * The 5 year estimated survival for benign tumors is 85.6%, 82.3% for borderline malignant tumors, and 66% for malignant tumors. A poorer survival rate may be seen in patients of advanced age, male patients, black race, malignant tumors, and patients with no initial treatment.<ref name="pmid25872752">{{cite journal| author=Dolecek TA, Dressler EV, Thakkar JP, Liu M, Al-Qaisi A, Villano JL| title=Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act. | journal=Cancer | year= 2015 | volume= 121 | issue= 14 | pages= 2400-10 | pmid=25872752 | doi=10.1002/cncr.29379 | pmc=5549267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25872752 }} </ref> | ||
* Patients with atypical meningioma have a higher overall recurrence-free survival rate than those with anaplastic meningioma.<ref name="pmid17766430">{{cite journal| author=Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW| title=Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. | journal=J Neurol Neurosurg Psychiatry | year= 2008 | volume= 79 | issue= 5 | pages= 574-80 | pmid=17766430 | doi=10.1136/jnnp.2007.121582 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17766430 }} </ref> | * Patients with atypical meningioma have a higher overall recurrence-free survival rate than those with anaplastic meningioma.<ref name="pmid17766430">{{cite journal| author=Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW| title=Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. | journal=J Neurol Neurosurg Psychiatry | year= 2008 | volume= 79 | issue= 5 | pages= 574-80 | pmid=17766430 | doi=10.1136/jnnp.2007.121582 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17766430 }} </ref> | ||
* The prognostic factors in patients with anaplastic meningioma include brain invasion, adjuvant radiotherapy, malignant progression, p53 over expression, and extent of resection.<ref name="pmid17766430">{{cite journal| author=Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW| title=Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. | journal=J Neurol Neurosurg Psychiatry | year= 2008 | volume= 79 | issue= 5 | pages= 574-80 | pmid=17766430 | doi=10.1136/jnnp.2007.121582 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17766430 }} </ref> | |||
* Depending on the [[histological]] grade of the meningioma at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.<ref name="Wiki">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#cite_ref-17 Accessed on September, 25 2015</ref> | * Depending on the [[histological]] grade of the meningioma at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.<ref name="Wiki">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#cite_ref-17 Accessed on September, 25 2015</ref> | ||
* Grade 1 meningioma is associated with a median survival of approximately 10 years.<ref name="pmid23463172">{{cite journal| author=Fathi AR, Roelcke U| title=Meningioma. | journal=Curr Neurol Neurosci Rep | year= 2013 | volume= 13 | issue= 4 | pages= 337 | pmid=23463172 | doi=10.1007/s11910-013-0337-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23463172 }} </ref> | * Grade 1 meningioma is associated with a median survival of approximately 10 years.<ref name="pmid23463172">{{cite journal| author=Fathi AR, Roelcke U| title=Meningioma. | journal=Curr Neurol Neurosci Rep | year= 2013 | volume= 13 | issue= 4 | pages= 337 | pmid=23463172 | doi=10.1007/s11910-013-0337-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23463172 }} </ref> | ||
Revision as of 15:54, 5 April 2019
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Meningioma natural history On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
If left untreated, patients with meningioma may progress to develop morning headache, focal neurological deficit, and altered mental status. Common complications of meningioma include increased intracranial pressure, cranial nerve palsies, and hydrocephalus. Prognosis is generally good, and the survival rate of patients with meningioma mainly depends on the grade and location of the tumor.[1][2]
Natural History
- The median age at diagnosis of meningioma is about 65 years, with incidence increasing with advancing age.[3]
- Most patients with meningioma are asymptomatic. If left untreated, patients with meningioma may progress to develop morning headache, focal neurological deficit, and altered mental status.[1]
- Absence of calcification, age 60 or younger, and initial tumor diameter of greater than 25mm are among the factors associated with a short time to progression.[4]
- Linear growth may be seen in 44% of patients, while volumetric growth may be seen in 74%.[4]
- A higher annual growth rate may be seen in patients with an initial tumor diameter of greater than 25mm, MR imaging T2 signal hyperintensity, patients presenting with symptoms and edema, and male patients.[4]
- Meningomas are usually single but can be multiple in about 1-10% of patients. Multiple meningiomas are usually seen in patients with neurofibromatosis.[5][6]
- The rate of growth in patients with multiple meningiomas is similar to those with solitary meningiomas.
- Meningiomas can grow anywhere in the central nervous system containing arachnoid membrane. For example, between the brain and the cranium, in the ventricles, down the spinal canal.[7]
Complications
- Common complications of meningioma include:[1]
Prognosis
- The 5 year estimated survival for benign tumors is 85.6%, 82.3% for borderline malignant tumors, and 66% for malignant tumors. A poorer survival rate may be seen in patients of advanced age, male patients, black race, malignant tumors, and patients with no initial treatment.[3]
- Patients with atypical meningioma have a higher overall recurrence-free survival rate than those with anaplastic meningioma.[8]
- The prognostic factors in patients with anaplastic meningioma include brain invasion, adjuvant radiotherapy, malignant progression, p53 over expression, and extent of resection.[8]
- Depending on the histological grade of the meningioma at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[1]
- Grade 1 meningioma is associated with a median survival of approximately 10 years.[2]
- Grade 3 meningioma is associated with a median survival of approximately 2.7 years.
- The table below lists common prognostic factors for meningioma:[9]
| Prognostic Factor | Description |
| Age | Older age is associated with a worse prognosis |
| Anatomical location | Meningioma located at the base of the skull is associated with a poor prognosis due to difficult surgical resection. |
| Labeling index using MIB-1 test | A greater MIB-1 labeling index is associated with a worse prognosis. |
| Histological grade | A grade 3 anaplastic meningioma is associated with the worst prognosis. |
| Functional neurological status | Low score on the Karnofsky Performance Scale is associated with a worse prognosis. |
| Sex hormone receptor | Meningiomas that lack progesterone receptors are associated with a worse prognosis due to a higher recurrence rate following surgery.[2] |
References
- ↑ 1.0 1.1 1.2 1.3 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#cite_ref-17 Accessed on September, 25 2015
- ↑ 2.0 2.1 2.2 Fathi AR, Roelcke U (2013). "Meningioma". Curr Neurol Neurosci Rep. 13 (4): 337. doi:10.1007/s11910-013-0337-4. PMID 23463172.
- ↑ 3.0 3.1 Dolecek TA, Dressler EV, Thakkar JP, Liu M, Al-Qaisi A, Villano JL (2015). "Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act". Cancer. 121 (14): 2400–10. doi:10.1002/cncr.29379. PMC 5549267. PMID 25872752.
- ↑ 4.0 4.1 4.2 Oya S, Kim SH, Sade B, Lee JH (2011). "The natural history of intracranial meningiomas". J Neurosurg. 114 (5): 1250–6. doi:10.3171/2010.12.JNS101623. PMID 21250802.
- ↑ Wong RH, Wong AK, Vick N, Farhat HI (2013). "Natural history of multiple meningiomas". Surg Neurol Int. 4: 71. doi:10.4103/2152-7806.112617. PMC 3683641. PMID 23776757.
- ↑ Sheehy JP, Crockard HA (1983). "Multiple meningiomas: a long-term review". J Neurosurg. 59 (1): 1–5. doi:10.3171/jns.1983.59.1.0001. PMID 6864264.
- ↑ Sumkovski R, Micunovic M, Kocevski I, Ilievski B, Petrov I (2019). "Surgical Treatment of Meningiomas - Outcome Associated With Type of Resection, Recurrence, Karnofsky Performance Score, Mitotic Count". Open Access Maced J Med Sci. 7 (1): 56–64. doi:10.3889/oamjms.2018.503. PMC 6352459. PMID 30740161.
- ↑ 8.0 8.1 Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW (2008). "Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features". J Neurol Neurosurg Psychiatry. 79 (5): 574–80. doi:10.1136/jnnp.2007.121582. PMID 17766430.
- ↑ Meningioma: Stages and Grades Cancer.net(2015) http://www.cancer.net/cancer-types/meningioma/stages-and-grades Accessed on September, 25 2015