| Title: |
Volumetric Growth and Growth Curve Analysis of Residual Intracranial Meningioma |
| Authors: |
Gillespie, CS; Richardson, GE; Mustafa, MA; Taweel, BA; Bakhsh, A; Kumar, S; Keshwara, SM; Islim, AI; Mehta, S; Millward, CP; Brodbelt, AR; Mills, SJ; Jenkinson, MD |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2023 |
| Collection: |
The University of Liverpool Repository |
| Description: |
BACKGROUND: After meningioma surgery, approximately 1 in 3 patients will have residual tumor that requires ongoing imaging surveillance. The precise volumetric growth rates of these tumors are unknown. OBJECTIVE: To identify the volumetric growth rates of residual meningioma, growth trajectory, and factors associated with progression. METHODS: Patients with residual meningioma identified at a tertiary neurosurgery center between 2004 and 2020 were retrospectively reviewed. Tumor volume was measured using manual segmentation, after surgery and at every follow-up MRI scan. Growth rates were ascertained using a linear mixed-effects model and nonlinear regression analysis of growth trajectories. Progression was defined according to the Response Assessment in Neuro-Oncology (RANO) criteria (40% volume increase). RESULTS: There were 236 patients with residual meningioma. One hundred and thirty-two patients (56.0%) progressed according to the RANO criteria, with 86 patients being conservatively managed (65.2%) after progression. Thirteen patients (5.5%) developed clinical progression. Over a median follow-up of 5.3 years (interquartile range, 3.5–8.6 years), the absolute growth rate was 0.11 cm 3 per year and the relative growth rate 4.3% per year. Factors associated with residual meningioma progression in multivariable Cox regression analysis were skull base location (hazard ratio [HR] 1.60, 95% CI 1.02–2.50) and increasing Ki-67 index (HR 3.43, 95% CI 1.19–9.90). Most meningioma exhibited exponential and logistic growth patterns (median R 2 value 0.84, 95% CI 0.60–0.90). CONCLUSION: Absolute and relative growth rates of residual meningioma are low, but most meet the RANO criteria for progression. Location and Ki-67 index can be used to stratify adjuvant treatment and surveillance paradigms. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0148-396X |
| Relation: |
https://livrepository.liverpool.ac.uk/3167094/1/Volumetric_Growth_and_Growth_Curve_Analysis_of.515.pdf; Collapse authors list. Gillespie, CS, Richardson, GE, Mustafa, MA, Taweel, BA orcid:0000-0002-6157-2438 , Bakhsh, A, Kumar, S orcid:0000-0001-8084-2504 , Keshwara, SM, Islim, AI, Mehta, S, Millward, CP orcid:0000-0001-7727-1157 et al (show 3 more authors) , Brodbelt, AR, Mills, SJ orcid:0000-0002-1017-6654 and Jenkinson, MD orcid:0000-0003-4587-2139 (2023) Volumetric Growth and Growth Curve Analysis of Residual Intracranial Meningioma Neurosurgery, 92 (4). pp. 734-744. ISSN 0148-396X, 1524-4040 |
| DOI: |
10.1227/neu.0000000000002268 |
| Availability: |
https://livrepository.liverpool.ac.uk/3167094/; https://doi.org/10.1227/neu.0000000000002268; https://livrepository.liverpool.ac.uk/3167094/1/Volumetric_Growth_and_Growth_Curve_Analysis_of.515.pdf |
| Accession Number: |
edsbas.52DCD197 |
| Database: |
BASE |