Bone involvement predicts poor outcome in atypical meningioma: Clinical article

Darlene Gabeau-Lacet, Manish Aghi, Rebecca Betensky, Fred G. Barker, Jay S. Loeffler, David N. Louis

Research output: Contribution to journalArticle

Abstract

Object. The authors identified clinical features associated with progression and death in atypical meningioma (AM). Methods. Forty-seven cases of primary AM treated at Massachusetts General Hospital were retrospectively evaluated for clinical features. Associations with progression-free survival (PFS) and overall survival were assessed. Results. The estimated median PFS was 56 months (95% CI 35 months-not estimable). The overall 3- and 5-year PFS rates were 65% (95% CI 44-80%) and 48% (95% CI 26-67%), respectively. The median survival time and 5- and 10-year survival rates were 158 months (95% CI 103 months-not estimable), and 86% (95% CI 69-94%) and 61% (95% CI 35-79%), respectively. Subtotal resection was associated with increased rate of progression compared to gross-total resection (p = 0.05) and trended toward an association with decreased survival (p = 0.09). Bone involvement was associated with an increased rate of disease progression (p = 0.001) and decreased survival (p = 0.04). Bone involvement remained significantly associated with progression after Bonferroni adjustment for multiple comparisons (p = 0.008) and in bivariate Cox regression models. Seventy-eight percent of patients with bone involvement at primary diagnosis had tumor recurrence within bone, whereas only 25% of patients without evidence of bone invasion at primary diagnosis experienced osseous recurrence. Conclusions. Osseous involvement is associated with a poor outcome in patients with AMs; bone assessment is therefore extremely important. Further investigation is warranted to assess the effectiveness of bone resection and/or bone-directed radiation therapy in improving outcome.

Original languageEnglish (US)
Pages (from-to)464-471
Number of pages8
JournalJournal of Neurosurgery
Volume111
Issue number3
DOIs
StatePublished - Dec 7 2009

Fingerprint

Meningioma
Bone and Bones
Disease-Free Survival
Survival
Survival Rate
Recurrence
Proportional Hazards Models
General Hospitals
Disease Progression
Radiotherapy

Keywords

  • Atypical meningioma
  • Bone invasion
  • Progression
  • Subtotal resection
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Gabeau-Lacet, D., Aghi, M., Betensky, R., Barker, F. G., Loeffler, J. S., & Louis, D. N. (2009). Bone involvement predicts poor outcome in atypical meningioma: Clinical article. Journal of Neurosurgery, 111(3), 464-471. https://doi.org/10.3171/2009.2.JNS08877

Bone involvement predicts poor outcome in atypical meningioma : Clinical article. / Gabeau-Lacet, Darlene; Aghi, Manish; Betensky, Rebecca; Barker, Fred G.; Loeffler, Jay S.; Louis, David N.

In: Journal of Neurosurgery, Vol. 111, No. 3, 07.12.2009, p. 464-471.

Research output: Contribution to journalArticle

Gabeau-Lacet, D, Aghi, M, Betensky, R, Barker, FG, Loeffler, JS & Louis, DN 2009, 'Bone involvement predicts poor outcome in atypical meningioma: Clinical article', Journal of Neurosurgery, vol. 111, no. 3, pp. 464-471. https://doi.org/10.3171/2009.2.JNS08877
Gabeau-Lacet, Darlene ; Aghi, Manish ; Betensky, Rebecca ; Barker, Fred G. ; Loeffler, Jay S. ; Louis, David N. / Bone involvement predicts poor outcome in atypical meningioma : Clinical article. In: Journal of Neurosurgery. 2009 ; Vol. 111, No. 3. pp. 464-471.
@article{c59b8d22bdf645068ce73b28eb7b8cde,
title = "Bone involvement predicts poor outcome in atypical meningioma: Clinical article",
abstract = "Object. The authors identified clinical features associated with progression and death in atypical meningioma (AM). Methods. Forty-seven cases of primary AM treated at Massachusetts General Hospital were retrospectively evaluated for clinical features. Associations with progression-free survival (PFS) and overall survival were assessed. Results. The estimated median PFS was 56 months (95{\%} CI 35 months-not estimable). The overall 3- and 5-year PFS rates were 65{\%} (95{\%} CI 44-80{\%}) and 48{\%} (95{\%} CI 26-67{\%}), respectively. The median survival time and 5- and 10-year survival rates were 158 months (95{\%} CI 103 months-not estimable), and 86{\%} (95{\%} CI 69-94{\%}) and 61{\%} (95{\%} CI 35-79{\%}), respectively. Subtotal resection was associated with increased rate of progression compared to gross-total resection (p = 0.05) and trended toward an association with decreased survival (p = 0.09). Bone involvement was associated with an increased rate of disease progression (p = 0.001) and decreased survival (p = 0.04). Bone involvement remained significantly associated with progression after Bonferroni adjustment for multiple comparisons (p = 0.008) and in bivariate Cox regression models. Seventy-eight percent of patients with bone involvement at primary diagnosis had tumor recurrence within bone, whereas only 25{\%} of patients without evidence of bone invasion at primary diagnosis experienced osseous recurrence. Conclusions. Osseous involvement is associated with a poor outcome in patients with AMs; bone assessment is therefore extremely important. Further investigation is warranted to assess the effectiveness of bone resection and/or bone-directed radiation therapy in improving outcome.",
keywords = "Atypical meningioma, Bone invasion, Progression, Subtotal resection, Survival",
author = "Darlene Gabeau-Lacet and Manish Aghi and Rebecca Betensky and Barker, {Fred G.} and Loeffler, {Jay S.} and Louis, {David N.}",
year = "2009",
month = "12",
day = "7",
doi = "10.3171/2009.2.JNS08877",
language = "English (US)",
volume = "111",
pages = "464--471",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "3",

}

TY - JOUR

T1 - Bone involvement predicts poor outcome in atypical meningioma

T2 - Clinical article

AU - Gabeau-Lacet, Darlene

AU - Aghi, Manish

AU - Betensky, Rebecca

AU - Barker, Fred G.

AU - Loeffler, Jay S.

AU - Louis, David N.

PY - 2009/12/7

Y1 - 2009/12/7

N2 - Object. The authors identified clinical features associated with progression and death in atypical meningioma (AM). Methods. Forty-seven cases of primary AM treated at Massachusetts General Hospital were retrospectively evaluated for clinical features. Associations with progression-free survival (PFS) and overall survival were assessed. Results. The estimated median PFS was 56 months (95% CI 35 months-not estimable). The overall 3- and 5-year PFS rates were 65% (95% CI 44-80%) and 48% (95% CI 26-67%), respectively. The median survival time and 5- and 10-year survival rates were 158 months (95% CI 103 months-not estimable), and 86% (95% CI 69-94%) and 61% (95% CI 35-79%), respectively. Subtotal resection was associated with increased rate of progression compared to gross-total resection (p = 0.05) and trended toward an association with decreased survival (p = 0.09). Bone involvement was associated with an increased rate of disease progression (p = 0.001) and decreased survival (p = 0.04). Bone involvement remained significantly associated with progression after Bonferroni adjustment for multiple comparisons (p = 0.008) and in bivariate Cox regression models. Seventy-eight percent of patients with bone involvement at primary diagnosis had tumor recurrence within bone, whereas only 25% of patients without evidence of bone invasion at primary diagnosis experienced osseous recurrence. Conclusions. Osseous involvement is associated with a poor outcome in patients with AMs; bone assessment is therefore extremely important. Further investigation is warranted to assess the effectiveness of bone resection and/or bone-directed radiation therapy in improving outcome.

AB - Object. The authors identified clinical features associated with progression and death in atypical meningioma (AM). Methods. Forty-seven cases of primary AM treated at Massachusetts General Hospital were retrospectively evaluated for clinical features. Associations with progression-free survival (PFS) and overall survival were assessed. Results. The estimated median PFS was 56 months (95% CI 35 months-not estimable). The overall 3- and 5-year PFS rates were 65% (95% CI 44-80%) and 48% (95% CI 26-67%), respectively. The median survival time and 5- and 10-year survival rates were 158 months (95% CI 103 months-not estimable), and 86% (95% CI 69-94%) and 61% (95% CI 35-79%), respectively. Subtotal resection was associated with increased rate of progression compared to gross-total resection (p = 0.05) and trended toward an association with decreased survival (p = 0.09). Bone involvement was associated with an increased rate of disease progression (p = 0.001) and decreased survival (p = 0.04). Bone involvement remained significantly associated with progression after Bonferroni adjustment for multiple comparisons (p = 0.008) and in bivariate Cox regression models. Seventy-eight percent of patients with bone involvement at primary diagnosis had tumor recurrence within bone, whereas only 25% of patients without evidence of bone invasion at primary diagnosis experienced osseous recurrence. Conclusions. Osseous involvement is associated with a poor outcome in patients with AMs; bone assessment is therefore extremely important. Further investigation is warranted to assess the effectiveness of bone resection and/or bone-directed radiation therapy in improving outcome.

KW - Atypical meningioma

KW - Bone invasion

KW - Progression

KW - Subtotal resection

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=70350513883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350513883&partnerID=8YFLogxK

U2 - 10.3171/2009.2.JNS08877

DO - 10.3171/2009.2.JNS08877

M3 - Article

C2 - 19267533

AN - SCOPUS:70350513883

VL - 111

SP - 464

EP - 471

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 3

ER -