Hier stelle ich Artikel ein, die ich zu diesem Thema gefunden habe. Recherchiert über medline, den ganzen Text finden Sie in der nächstgelegenen Uni-Bibliothek.
Quelle: J Neurosurg 1983 Jan;58(1):51-6
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The recurrence of intracranial meningiomas after surgical treatment.Autoren: Adegbite AB, Khan MI, Paine KW, Tan LK.
A study of 114 surgically treated patients with intracranial meningiomas was carried out to evaluate factors influencing recurrence. The data of the initial surgery extended over a 24-year period from January, 1956, to December, 1979. The patients ranged in age from 1 1/2 years to 82 years. Seventy-one (62.3%) were females and 43 (37.7%) were males. The surgical procedure was graded according to Simpson's classification from 1 to 5 (Grade 1 = complete excision, Grade 5 = simple decompression). In this series, 33 procedures (28.9%) were Grade 1, 55 (48.2%) were Grade 2, seven (6.1%) were Grade 3, 18 (15.8%) were Grade 4, and one (0.9%) was Grade 5. There were eight (7%) postoperative deaths. Approximately 60% of the tumors were located in the sphenoid wing (23.7%), convexity (21.1%), and parasagittally (14.9%). Histological diagnosis in 96% of the patients was transitional (42.1%), syncytial (34.2%), and fibroblastic (20.2%) meningiomas. Eight (7%) patients received postoperative radiotherapy. There was evidence of recurrence in 22 patients (19.3%). Twenty-one underwent a second surgical procedure. Using survival analysis, it was determined that 80% of the patients were free of recurrence 5 years after the initial surgery, and approximately 50% showed no recurrence 20 years after the initial surgery. Only the grade of the initial surgery had a statistically significant influence on recurrence. Sex of patients, site and histology of the tumor, and postoperative radiotherapy had no statistically significant influence on recurrence. Angioblastic and malignant meningiomas were rare (only four cases), and recurred relatively quickly.<
Quelle: J Neurosurg 1985 Jan;62(1):18-24
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Meningioma: analysis of recurrence and progression following neurosurgical resection.Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL.
The rates of survival, tumor recurrence, and tumor progression were analyzed in 225 patients with meningioma who underwent surgery as the only treatment modality between 1962 and 1980. Patients were considered to have a recurrence if their studies verified a mass effect in spite of a complete surgical removal, whereas they were defined as having progression if, after a subtotal excision, there was clear radiological documentation of an increase in the size of their tumor. There were 168 females and 57 males (a ratio of 2.9:1), with a peak incidence of tumor occurrence in the fifth (23%), sixth (29%), and seventh (23%) decades of life. Anatomical locations were the convexity (21%), parasagittal area (17%), sphenoid ridge (16%), posterior fossa (14%), parasellar region (12%), olfactory groove (10%), spine (8%), and orbit (2%). The absolute 5-, 10-, and 15-year survival rates were 83%, 77%, and 69%, respectively. Following a total resection, the recurrence-free rate at 5, 10, and 15 years was 93%, 80%, and 68%, respectively, at all sites. In contrast, after a subtotal resection, the progression-free rate was only 63%, 45%, and 9% during the same period (p less than 0.0001). The probability of having a second operation following a total excision after 5, 10, and 15 years was 6%, 15%, and 20%, whereas after a subtotal excision the probability was 25%, 44%, and 84%, respectively (p less than 0.0001). Tumor sites associated with a high percentage of total excisions had a low recurrence/progression rate. For example, 96% of convexity meningiomas were removed in toto, and the recurrence/progression rate at 5 years was only 3%. Parasellar meningiomas, with a 57% total excision rate, had a 5-year probability of recurrence/progression of 19%. Only 28% of sphenoid ridge meningiomas a second resection, the probability of a third operation at 5 and 10 years was 42% and 56%, respectively. There was no difference in the recurrence/progression rates according to the patients' age or sex, or the duration of symptoms. Implications for the potential role of adjunctive medical therapy or radiation therapy for meningiomas are discussed.<
Eine neue Publikation über den Zusammenhang von Progesteron-Rezeptoren an der Oberfläche von Meningeomen und der Rezidivgefahr. Recherchiert über medline (
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi).
Quelle: In Vivo 2002 Jul-Aug;16(4):265-70
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The impact of progesterone receptor expression on relapse in the long-term clinical course of 93 benign meningiomas.(Sinngemäß etwa: Progesteron-Rezeptoren und Rezidivgefahr: eine Langzeituntersuchung von 93 Fällen von gutartigen Meningeomen)
Strik HM, Strobelt I, Pietsch-Breitfeld B, Iglesias-Rozas JR, Will B, Meyermann R.
Institute of Brain Research, University of Tubingen. herwig.strik@med.uni-goettingen.de
BACKGROUND: Previous clinicopathological observations have pointed towards an impact of progesterone receptor (PgR) expression on the clinical course of meningiomas.
MATERIALS AND METHODS: Expression of PgR and the proliferation marker MIB-1 was assessed by immunohistochemistry in the primary tumours of 30 cases of benign, completely resected, recurrent meningiomas and compared with 63 cases of meningioma without recurrence for 14 or more years.
RESULTS: Univariate analysis showed a significantly higher risk for recurrence (odds ratio 3.533) for tumours with a low expression of PgR. A tendency for a higher risk for tumours with higher proliferation rate (odds ratio 6.889) was not significant. In 20 cases in which the primary tumour could be compared with its recurrence, no consistent changes of PgR expression were observed.
CONCLUSION: Our findings support previous studies that found an association of low or absent expression of PgR with a higher risk of recurrence. This encourages attempts at a hormonal therapy for patients with PgR-positive meningioma.<
Quelle: Journal of Clinical Oncology, Vol 21, Issue 17 (September), 2003: 3285-3295
© 2003 American Society for Clinical Oncology
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New Classification Scheme for the Prognostic Stratification of Meningioma on the Basis of Chromosome 14 Abnormalities, Patient Age, and Tumor Histopathology Angel Maíllo, Alberto Orfao, José María Sayagués, Pedro Díaz, Juan Antonio Gómez-Moreta, Marcelino Caballero, David Santamarta, Angel Santos-Briz, Francisco Morales, María Dolores Tabernero
From the Neurosurgery Service, Pathology Service, and Unidad de Investigación, Hospital Universitario de Salamanca; and Centro de Investigaciones del Cáncer, Cytometry General Service and Department of Medicine, University of Salamanca; Salamanca, Spain.
Address reprint requests to Angel Maíllo, MD, Servicio de Neurocirugía, Hospital Universitario de Salamanca, Paseo de San Vicente 58, 37007 Salamanca, Spain; e-mail: a_maillo@yahoo.es.
Purpose: Meningiomas are usually considered benign tumors. However, relapses occur in 10% to 20% of all patients, including both histopathologically aggressive and benign tumors. This study explored the value of numerical abnormalities for 10 different chromosomes in meningiomas for predicting relapse-free survival (RFS).
Patients and Methods: This study prospectively analyzed the frequency of numerical abnormalities of chromosomes 1, 9, 10, 11, 14, 15, 17, 22, X, and Y in 70 meningioma patients by fluorescence in situ hybridization and their relationship with disease characteristics at diagnosis and patients’ outcome.
Results: Results showed the presence of numerical abnormalities for one or more chromosomes in most patients (77%). Chromosome 22 in the whole series and chromosome Y in males were those more frequently altered, followed by chromosomes 1, 14, and X in females. Patients with abnormalities of chromosomes 1, 9, 10, 11, 14, 15, 17, the sex chromosomes, and gains of chromosome 22 were associated with adverse prognostic features, more frequent relapses, and shorter RFS. Multivariate analysis showed that tumor grade together with chromosome 14 status and age were the best combination of independent variables for predicting RFS. According to these variables, all patients with a score of two or more than two adverse prognostic factors had experienced relapse at 5 years, whereas none of those with a score of zero had experienced relapse 10 years after surgery.
Conclusion: In addition to age and histologic grade, abnormalities of chromosome 14 contribute to a better prognostic stratification of meningioma patients at diagnosis. Additional prospective studies in larger series of patients, also including larger numbers of patients who experienced relapse, are necessary to confirm the utility of the proposed predictive model. <
Thema: Rezidivrate intrakranieller Meningeome... (Gelesen 23143 mal)