Malignant transformation of WHO grade I meningiomas after surgery or radiosurgery: systematic review and meta-analysis of observational studies.
incidence
malignant transformation
meningioma
meta-analysis
radiosurgery
Journal
Neuro-oncology advances
ISSN: 2632-2498
Titre abrégé: Neurooncol Adv
Pays: England
ID NLM: 101755003
Informations de publication
Date de publication:
Historique:
entrez:
11
12
2020
pubmed:
12
12
2020
medline:
12
12
2020
Statut:
epublish
Résumé
The incidence and clinical features of the malignant transformation of benign meningiomas are poorly understood. This study examined the risk of the malignant transformation of benign meningiomas after surgery or stereotactic radiosurgery. We systematically reviewed studies published between 1979 and 2019 using PubMed, Scopus, and other sources. We analyzed pooled data according to the PRISMA guideline to clarify the incidence rate of malignant transformation (IMT) and factors affecting malignant transformation in surgically or radiosurgically treated benign meningiomas. IMT was 2.98/1000 patient-years (95% confidence interval [CI] = 1.9-4.3) in 13 studies in a single-arm meta-analysis. Although the evidence level of the included studies was low, the heterogeneity of the incidence was mostly explained by the tumor location. In meta-regression analysis, skull base tumors had a significantly lower IMT than non-skull base tumors, but no gender association was observed. IMT after radiosurgery in 9 studies was 0.50/1000 person-years (95% CI = 0.02-1.38). However, a higher proportion of skull base tumors, lower proportion of males, and lower salvage surgery rate were observed in the radiosurgery group than in the surgery group. The median time to malignant change was 5 years (interquartile range = 2.5-8.2), and the median survival after malignant transformation was 4.7 years (95% CI = 3.7-8) in individual case data. IMT of benign meningioma was significantly affected by the tumor location. Radiosurgery did not appear to increase IMT, but exact comparisons were difficult because of differences in study populations.
Sections du résumé
BACKGROUND
BACKGROUND
The incidence and clinical features of the malignant transformation of benign meningiomas are poorly understood. This study examined the risk of the malignant transformation of benign meningiomas after surgery or stereotactic radiosurgery.
METHODS
METHODS
We systematically reviewed studies published between 1979 and 2019 using PubMed, Scopus, and other sources. We analyzed pooled data according to the PRISMA guideline to clarify the incidence rate of malignant transformation (IMT) and factors affecting malignant transformation in surgically or radiosurgically treated benign meningiomas.
RESULTS
RESULTS
IMT was 2.98/1000 patient-years (95% confidence interval [CI] = 1.9-4.3) in 13 studies in a single-arm meta-analysis. Although the evidence level of the included studies was low, the heterogeneity of the incidence was mostly explained by the tumor location. In meta-regression analysis, skull base tumors had a significantly lower IMT than non-skull base tumors, but no gender association was observed. IMT after radiosurgery in 9 studies was 0.50/1000 person-years (95% CI = 0.02-1.38). However, a higher proportion of skull base tumors, lower proportion of males, and lower salvage surgery rate were observed in the radiosurgery group than in the surgery group. The median time to malignant change was 5 years (interquartile range = 2.5-8.2), and the median survival after malignant transformation was 4.7 years (95% CI = 3.7-8) in individual case data.
CONCLUSION
CONCLUSIONS
IMT of benign meningioma was significantly affected by the tumor location. Radiosurgery did not appear to increase IMT, but exact comparisons were difficult because of differences in study populations.
Identifiants
pubmed: 33305267
doi: 10.1093/noajnl/vdaa129
pii: vdaa129
pmc: PMC7712809
doi:
Types de publication
Journal Article
Langues
eng
Pagination
vdaa129Informations de copyright
© The Author(s) 2020. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
Références
Lancet Oncol. 2019 Jan;20(1):159-164
pubmed: 30473468
J Neurosurg. 2010 May;112(5):925-33
pubmed: 19799498
Neurol Med Chir (Tokyo). 2020 Mar 15;60(3):109-120
pubmed: 32009127
Br J Neurosurg. 2015;29(5):693-8
pubmed: 26098606
Neurosurg Rev. 2019 Mar;42(1):163-173
pubmed: 29627874
Neuro Oncol. 2010 Dec;12(12):1278-90
pubmed: 20685720
Acta Neurochir (Wien). 2019 Nov 9;:
pubmed: 31707459
NPJ Genom Med. 2017;2:
pubmed: 28713588
Mech Dev. 2008 Sep-Oct;125(9-10):797-808
pubmed: 18617001
Acta Neurol Belg. 2013 Dec;113(4):463-7
pubmed: 23709265
PLoS One. 2013;8(1):e54114
pubmed: 23349797
J Natl Cancer Inst. 2015 Dec 13;108(5):
pubmed: 26668184
No Shinkei Geka. 1990 Oct;18(10):939-46
pubmed: 2234295
J Neurol Neurosurg Psychiatry. 1957 Feb;20(1):22-39
pubmed: 13406590
Acta Neurochir (Wien). 2013 Mar;155(3):407-13
pubmed: 23318687
Asian J Neurosurg. 2019 Jan-Mar;14(1):41-46
pubmed: 30937006
No To Shinkei. 1996 Aug;48(8):719-25
pubmed: 8797205
Neurol Med Chir (Tokyo). 2011;51(6):415-22
pubmed: 21701104
Neuro Oncol. 2018 Jul 5;20(8):1113-1121
pubmed: 29216385
World Neurosurg. 2018 Apr;112:e74-e83
pubmed: 29258946
J Neurosurg. 2012 Mar;116(3):574-80
pubmed: 22175721
Brain Tumor Res Treat. 2015 Oct;3(2):103-7
pubmed: 26605265
J Neurosurg. 2004 Aug;101(2):210-8
pubmed: 15309910
Oper Neurosurg (Hagerstown). 2018 Apr 1;14(4):341-350
pubmed: 29554374
J Neurooncol. 2016 Sep;129(2):337-45
pubmed: 27311726
Acta Neurochir (Wien). 2004 Jan;146(1):37-44; discussion 44
pubmed: 14740263
Anticancer Res. 2004 Jul-Aug;24(4):2319-24
pubmed: 15330178
Neurosurg Focus. 2003 May 15;14(5):e5
pubmed: 15669816
J Neurol Neurosurg Psychiatry. 2008 May;79(5):574-80
pubmed: 17766430
J Neuropathol Exp Neurol. 2012 Oct;71(10):882-93
pubmed: 22964784
Turk Neurosurg. 2018;28(1):1-6
pubmed: 27593846
Neurosurg Focus. 2019 Jun 1;46(6):E7
pubmed: 31153153
Brain Pathol. 2014 Mar;24(2):184-9
pubmed: 24261697
Skull Base. 2008 Jul;18(4):243-52
pubmed: 19119339
Surg Neurol. 1986 Mar;25(3):233-42
pubmed: 3945904
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
J Neurooncol. 2018 Apr;137(2):331-336
pubmed: 29270884
Oncotarget. 2017 Nov 24;8(65):109228-109237
pubmed: 29312603
J Neurosurg. 1984 Jan;60(1):52-60
pubmed: 6689728
Am J Clin Oncol. 2016 Oct;39(5):453-7
pubmed: 24755664
Clin Neurol Neurosurg. 2016 Feb;141:117-21
pubmed: 26780494
J Neurosurg. 2016 Aug;125(2):431-40
pubmed: 26722844
J Neurosurg. 2019 Oct 25;:1-10
pubmed: 31653806
Neurosurgery. 2019 Sep 1;85(3):E461-E469
pubmed: 30566646
J Neurosurg. 2001 Oct;95(4):601-7
pubmed: 11596954
Brain Tumor Pathol. 2009;26(2):69-72
pubmed: 19856217
Neurosurgery. 2001 Nov;49(5):1029-37; discussion 1037-8
pubmed: 11846894
J Neurosurg. 2007 Aug;107(2):325-36
pubmed: 17695387
Anticancer Res. 2019 Nov;39(11):6299-6305
pubmed: 31704860
Neurosurg Rev. 2015 Jan;38(1):101-7; discussion 107
pubmed: 25139398
Neurosurgery. 2012 Jan;70(1):32-9; discussion 39
pubmed: 21765282
Neurosurgery. 2007 Sep;61(3):495-503; discussion 503-4
pubmed: 17881961
Neurosurgery. 2012 Sep;71(3):604-12; discussion 613
pubmed: 22710378
J Neurooncol. 2017 Jul;133(3):641-651
pubmed: 28527009
Nat Commun. 2018 Apr 20;9:16215
pubmed: 29676392
J Neurooncol. 2011 Apr;102(2):303-10
pubmed: 20686821
J Med Genet. 2006 Apr;43(4):289-94
pubmed: 16155191
Br J Neurosurg. 2005 Feb;19(1):13-20
pubmed: 16147577
J Neurooncol. 2005 Jun;73(2):125-30
pubmed: 15981101
Neurosurgery. 2018 Nov 1;83(5):1040-1049
pubmed: 29538718
J Neurol. 1975;208(4):279-98
pubmed: 50413