Medical Options, Remedy, and Prognostic Elements of 56 Intracranial and Intraspinal Clear Cell Meningiomas.
World Neurosurg. 2018 Mar;111:e880-e887
Authors: Tao X, Dong J, Hou Z, Hao S, Zhang J, Wu Z, Liu B
OBJECTIVE: Intracranial and intraspinal clear cell meningiomas (CCMs) are not often reported due to their extraordinarily low incidence, and the present understanding of CCM is poor. The aim of this research was to investigate the incidence and the medical, radiologic, pathologic, and prognostic options of intracranial and intraspinal CCMs.
METHODS: Amongst 14,310 instances of intracranial and intraspinal meningiomas that had been surgically handled between 2006 and 2016 at Beijing Tian Tan Hospital, 56 had been chosen for evaluation and retrospectively reviewed. To find out which parameters had been related to longer progression-free survival (PFS) and total survival (OS), statistical evaluation was carried out.
RESULTS: CCMs accounted for about zero.39% of all intracranial and intraspinal meningiomas. Sufferers with CCM had a imply age of 32.Three years and there was a feminine predilection (20 males and 36 females). Gross whole resection was achieved in 35 instances, and subtotal resection was achieved in 21 instances. All sufferers had been adopted up for 10-206 months after surgical procedure. Twenty-six sufferers skilled tumor recurrence, and the median PFS was 48.zero months. The 1-year, Three-year, and 5-year PFS was 87.5%, 59.eight%, and 41.eight%, respectively. Twelve sufferers died of tumor recurrence, and the median OS was not accessible. The 1-year, Three-year, and 5-year OS was 98.2%, 91.Three%, and 65.eight%, respectively. Univariate evaluation confirmed that whole tumor removing was considerably related to a greater prognosis. Multivariate evaluation confirmed solely Simpson grade III and IV resection as an unbiased threat issue for shorter PFS. Radiotherapy mildly improved PFS after each gross whole resection and subtotal resection, displaying no vital distinction due to the small pattern measurement and brief follow-up period.
CONCLUSIONS: CCM is a uncommon subtype of World Well being Group grade II meningioma. CCM sometimes entails younger sufferers and reveals a feminine predilection and excessive recurrence price. When doable, whole resection is the first and most fitted remedy for CCM. For sufferers with major tumors, radiotherapy is really helpful after the preliminary operation whatever the extent of resection. For sufferers with illness recurrence, secondary surgical procedure mixed with radiotherapy may function an efficient remedy.
PMID: 29325940 [PubMed – indexed for MEDLINE]