WHO grade II meningioma: Epidemiology, survival and contribution of postoperative radiotherapy in a multicenter cohort of 88 patients

• Published in: Neuro-chirurgie 2020-04, Vol.66 (2), p.73-79
• Main Authors: Poulen, G., Vignes, J.-R., Le Corre, M., Loiseau, H., Bauchet, L.
• Format: Article
• Language: English
• Subjects: Life Sciences; Meningioma; Neuro-oncology; Radiotherapy; WHO classification
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2019.12.008

Meningioma is the most common primary intracranial tumor, representing 13-36.6% of all primary central nervous system tumors. Meningiomas are benign in about 90% of cases. World Health Organization (WHO) grade II meningioma is associated with a high rate of recurrence and poorer survival than in grade I. The reference treatment is surgery, which should be as complete as possible. Currently, in grade II, there are no recommendations for systematic adjuvant treatment such as radiotherapy. We studied a homogeneous series of grade II meningiomas treated by surgery in two university hospital centers to analyze use of radiotherapy and its efficacy. We retrospectively analyzed patients in our database with WHO grade II meningioma, operated on between 2007 and 2010 in the university hospitals of Montpellier and Bordeaux, France. Clinical and radiological data, treatments and survival were analyzed. Eighty-eight patients were included. Five-year overall survival was 89.7%. Nineteen patients received radiotherapy during follow-up, without significant impact on survival (P=0.27). In WHO grade II meningioma, it is currently difficult to establish clear recommendations for radiotherapy. The present study is in accordance with the literature that early postoperative radiotherapy is not mandatory in grade II meningioma with macroscopically total resection.