Predictor factors for recurrence in atypical meningiomas

Vol. 64 No. 3, 2023


Andrei Ionut Cucu, Claudia Florida Costea, Serban Turliuc, Laurentiu Andrei Blaj, Iulian Prutianu, Gabriela Florenta Dumitrescu, Cristina Gena Dascalu, Ion Poeata, Mihaela Cosman, Ana-Cristina Istrate, Georgiana Macovei, Ligia Gabriela Tataranu

Background and Objectives: Atypical meningiomas (AMs), World Health Organization (WHO) grade 2, are a group of tumors with uneven and unpredictable clinical behavior. Our aim was to analyze possible tumor recurrence predictors, and to identify factors that improve progression-free survival (PFS). Patients, Materials and Methods: Our retrospective study included 81 patients followed up in the Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iasi, Romania, between 1 January 2010 and 31 December 2020. The histopathological specimens were reviewed according to the WHO 2021 criteria. Analyses included clinical, imaging, pathological and surgical factors. Results: The tumor recurred in 53.1% of the 81 cases within 60 months of surgery. Tumor location (p<0.000), tumor volume (p<0.010), extent of surgical resection (p<0.000) and dural sinus invasion (p<0.001) were predictive factors of recurrence. Gross total resection (Simpson grade I and II) was achieved in 59.2% of patients. Patients with the tumors located in the brain convexity and volume <26.4 cm(3) had better survival rates up to recurrence. PFS showed a significant relationship between Simpson grade I-III and biopsy (p<0.000) and was statistically influenced by tumor volume and location, and dural sinus invasion. Conclusions: AMs are a heterogeneous group of tumors, and we identified posterior fossa location, volume >=26.4 cm(3), Simpson grade III and IV resection and dural sinus invasion as predictive factors for relapse and a shorter PFS. Whereas certain characteristics provide some prognostic value, future molecular characterizations of AMs are necessary, which will support the clinical decision-making process.

Corresponding author: Serban Turliuc, Associate Professor, MD, PhD; e-mail:; Georgiana Macovei, Associate Professor, MD, PhD; e-mail:

DOI: 10.47162/RJME.64.3.05 Download PDF
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