P12.26 Outcomes analysis of malignant meningioma (WHO III) patients from a single institution

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2017-05, Vol.19 (suppl_3), p.iii100-iii100
• Main Authors: Stevens, G. H., Sharma, M.
• Format: Article
• Language: English
• Subjects: POSTER PRESENTATIONS
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/nox036.383

Purpose : To retrospectively analyze and assess the outcomes and prognostic factors in patients with malignant meningioma (WHO Grade III). Materials/Methods: Clinical data and outcome (overall (OS) and recurrence-free (RFS) survival) from 18 patients with Grade III meningioma (MM, based on World Health Organization 2007 definition) initially treated between March 2000 and June 2015 were analyzed. 61% (11/18) of patients were male, median age at diagnosis was 63 (range 48-86), and 55% (10/18 patients) had good performance status (KPS≥80). 7 patients (39%) had lower grade disease (grade I - n=2; grade II - n=5) 6.7-218.2 months prior to diagnosis of MM (median 29.2 months). A total of 26 surgeries were performed (18 primary and 8 salvage). Also, 37 courses of radiotherapy (RT) were performed, including fractionated RT in 10 patients after primary surgery, salvage fractionated RT in 8 patients, stereotactic radiosurgery (SRS) boost along with primary RT in 1 patient and salvage SRS to 18 separate areas in 8 patients. Salvage chemotherapy was mainly considered in third or fourth recurrences. Results: 13 (72%) patients recurred and 11 (61%) have died. Follow-up for the 7 patients still being followed ranges from 5.0-75.4 months (median 38.5). The median time to recurrence was 14.5 months (95% C.I. 6.9-22.2). The 5-year survival rate was 36%± 14% and median OS was 55.8 months (95% C.I. 23.7-80.3). Of all factors, only performance status (KPS) affected outcome (RFS p=.0003; OS p=.002). CONCLUSION: Our results though consistent with existing reports of the overall poor outcomes for MM patients, shows a better median OS of 4.6 years compared to 3.4 years reported earlier from our institution. From the available data, surgical resection followed by RT and salvage radiosurgery and/or chemotherapy can lead to extended survival; however the benefit may decrease with successive treatments.