Treatment outcomes of 17 patients with atypical spinal meningioma, including 4 with metastases: a retrospective observational study

• Published in: The spine journal 2019-02, Vol.19 (2), p.276-284
• Main Authors: Noh, Sung Hyun, Kim, Kyung Hyun, Shin, Dong Ah, Park, Jeong Yoon, Yi, Seong, Kuh, Sung Uk, Kim, Keung Nyun, Chin, Dong Kyu, Kim, Keun Su, Yoon, Do Heum, Cho, Yong Eun
• Format: Article
• Language: English
• Subjects: Adjuvant therapy; Adult; Aged; Aged, 80 and over; Atypical meningioma Atypical spinal meningioma; Complete resection Metastasis; Female; Humans; Male; Meningeal Neoplasms - pathology; Meningeal Neoplasms - surgery; Meningioma - pathology; Meningioma - surgery; Middle Aged; Neoplasm Metastasis; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - methods; Postoperative Complications - epidemiology; Spinal cord; Spinal Cord Neoplasms - pathology; Spinal Cord Neoplasms - surgery; Treatment Outcome
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2018.06.006

Because of the scarcity of atypical spinal meningioma, there is a lack of research on this type of tumor or its associated metastases. The aim of this study was to investigate the biological behavior of atypical spinal meningioma and identify its prognostic factors by reviewing surgical and clinical outcomes of patients with these tumors. A retrospective chart review was performed. We retrospectively reviewed the data from all patients who underwent spinal cord tumor excision between 1994 and 2017. Seventeen patients were pathologically proven to have atypical spinal meningioma. We examined patients’ neurologic status by determining their Nurick scores before and after surgery. Moreover, imaging studies, laboratory data, and the employed surgical method were analyzed retrospectively, as was the Ki-67 index and prognosis following postoperative radiation therapy. The ranges, locations, and pathologic diagnoses of the tumors were extracted from the radiological and pathological records of each patient. The extent of surgery and progression of disease were confirmed using postoperative enhanced magnetic resonance imaging. Patients were divided into two atypical spinal meningioma groups: primary and metastatic. The demographics, age, sex, presenting symptom duration, tumor location, Simpson resection grade, Ki-67, radiotherapy, recurrence, overall survival, and progression-free survival of patients in both groups were compared. Seventeen patients were included in the analysis, of whom 12 (70%), 4 (24%), and 1 (6%) had tumors in the thoracic, cervical, and sacral regions, respectively. Complete and subtotal resections were achieved in 15 (88%) and 2 (12%) patients, respectively. Overall and progression-free survival rates in patients who underwent complete resection were longer than those in patients who underwent subtotal resection (p