Clinical analysis of 74 cases of atypical meningiomas

CHEN Fuye; ZHOU Han; FENG Yugong; ZHANG Liyun; LI Huanting; LI Shifang; GUO Pin; ZHANG Hongliang

Abstract：Objective The pre-operative diagnosis,treatment and prognostic factors of atypical meningiomas were discussed.Methods The clinical data of 74 cases of pathologically confirmed atypical meningioma admitted to Neurosurgical Department of Affiliated Hospital of Qingdao University from 2008 to 2016 were collected and analyzed retrospectively.All the data were processed by Log-rank method and Cox regression for statistical analysis,and the characteristics,treatment and prognosis of the disease were analyzed.Results Of all the 74 patients with atypical meningiomas,62 patients underwent total resection (83.8％) and 36 patients underwent radiotherapy.The median progression-free-survival (PFS) was 71.8 (9 ～ 110 months),and the progression-free-survival (PFS) rate was 79.5％ and 70.5％ for 2 years and 5 years,respectively;overall survival (OS) was 20 ～ 110 months,the median overall survival (OS) was 82.2 months,overall survival (OS) rate for 2 years and 5 years was 94.5％ and 90.1％,respectively.Univariate analysis showed that the first symptom of bone invasion and the proliferation index (Ki67) ≥10％ increased the risk of recurrence (P ＜ 0.05).Multivariate analysis showed that the initial symptom was bone invasion and the proliferation index (Ki67) ≥10％ increased the risk of recurrence (P ＜0.05).The patients with Kamofsky (KPS) ≥80 got a longer survival time (P ＜0.05).Conclusion Surgical resection is the most important method to improve the prognosis of patients with atypical meningioma.For patients without total resection,postoperative radiotherapy is recommended.The first symptom as hemiplegia,bone attack and/or proliferation index (Ki67) ≥10％ are regarded as the factors of easy recurrence for patients with total resection.If more than one factor is presented,post-operative auxiliary radiotherapy is recommended with a radiotherapy dose of 50 ～60 Gy.