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Prognostic Characterization of Higher-Grade Meningiomas: A Histopathological Score to Predict Progression and Outcome.
Bertero, Luca; Dalla Dea, Giulia; Osella-Abate, Simona; Botta, Cristina; Castellano, Isabella; Morra, Isabella; Pollo, Bianca; Calatozzolo, Chiara; Patriarca, Silvia; Mantovani, Cristina; Rudà, Roberta; Tardivo, Valentina; Zenga, Francesco; Garbossa, Diego; Papotti, Mauro; Soffietti, Riccardo; Ricardi, Umberto; Cassoni, Paola.
Afiliación
  • Bertero L; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
  • Dalla Dea G; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
  • Osella-Abate S; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
  • Botta C; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
  • Castellano I; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
  • Morra I; Pathology Unit, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Pollo B; Neuropathology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy.
  • Calatozzolo C; Neuropathology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy.
  • Patriarca S; Piedmont Cancer Registry - CRPT, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Mantovani C; Radiation Oncology Unit, Department of Oncology, University of Turin, Torino, Italy.
  • Rudà R; Neuro-oncology Unit, Department of Neurosciences, University of Turin, Torino, Italy.
  • Tardivo V; Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy.
  • Zenga F; Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy.
  • Garbossa D; Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy.
  • Papotti M; Pathology Unit, Department of Oncology, University of Turin, Torino, Italy.
  • Soffietti R; Neuro-oncology Unit, Department of Neurosciences, University of Turin, Torino, Italy.
  • Ricardi U; Radiation Oncology Unit, Department of Oncology, University of Turin, Torino, Italy.
  • Cassoni P; Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy.
J Neuropathol Exp Neurol ; 78(3): 248-256, 2019 03 01.
Article en En | MEDLINE | ID: mdl-30689922
Higher-grade meningiomas (WHO grade II and III) represent a diagnostic and prognostic challenge. We assessed the pathological and molecular characteristics of 94 higher-grade meningiomas (85 grade II, 9 grade III) to identify novel prognostic parameters. Higher mitotic count (p = 0.018), diffuse (≥50%) prominent nucleoli (p < 0.001), and sheeting (p < 0.001) were associated with recurrence. Lower SSTR2a-positive cells median rate (p = 0.048) and TERT promoter mutations (p = 0.014) were associated with recurrence and patient death, respectively; further analyses did not identify other outcome associations. Presence of Ki67 hot spots was associated with a shorter progression-free survival (PFS), independently of WHO grade at multivariate analysis (HR = 3.35, p = 0.008). Necrosis was related to a poorer overall survival (OS) at univariate (focal: HR = 4.55, p = 0.041 and diffuse: HR = 7.38, p = 0.020) and Kaplan-Meier analyses. A prognostic score was designed based on previous results: Presence of diffuse (≥50%) prominent nucleoli (0/1 point), diffuse (≥50%) sheeting (0/1 point), focal (<50%) or diffuse (≥50%) necrosis (0/1/2 points), and Ki67 hot spots (0/1 point). A total score ≥4 predicted poorer PFS and OS by Kaplan-Meier (PFS: 1.7 vs 6.4 years, p < 0.001 and OS: 5.2 vs 10.8 years, p = 0.001) and multivariate (PFS: HR = 5.98, p < 0.001 and OS: HR = 2.99, p = 0.048) analyses. These results were confirmed in an independent series of 58 grade II meningiomas (PFS: HR = 7.22, p = 0.002 and OS: HR = 9.69, p = 0.003). These associations and the integrated score could complement WHO grading.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Progresión de la Enfermedad / Neoplasias Meníngeas / Meningioma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neuropathol Exp Neurol Año: 2019 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Progresión de la Enfermedad / Neoplasias Meníngeas / Meningioma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neuropathol Exp Neurol Año: 2019 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido