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  • Resected WHO grade I mening...
    Nowak-Choi, Kamila; Palmer, Joshua D.; Casey, James; Chitale, Ameet; Kalchman, Ingrid; Buss, Elizabeth; Keith, Scott W.; Hegarty, Sarah E; Curtis, Mark; Solomides, Charalambos; Shi, Wenyin; Judy, Kevin; Andrews, David W.; Farrell, Christopher; Werner-Wasik, Maria

    Journal of neuro-oncology, 03/2021, Letnik: 152, Številka: 1
    Journal Article

    Introduction Despite optimal surgical resection, meningiomas may recur, with increasing grade and the degree of resection being predictive of risk. We hypothesize that an increasing Ki67 correlates with a higher risk of recurrence of resected WHO grade I meningiomas. Methods The study population consisted of patients with resected WHO grade 1 meningiomas in locations outside of the base of skull. Digitally scanned slides stained for Ki67 were analyzed using automatic image analysis software in a standardized fashion. Results Recurrence was observed in 53 (17.7%) of cases with a median follow up time of 25.8 months. Ki67 ranged from 0 to 30%. Median Ki67 was 5.1% for patients with recurrence and 3.5% for patients without recurrence. In unadjusted analyses, high Ki-67 (≥ 5 vs. < 5) vs. ≥ 5) was associated with over a twofold increased risk of recurrence (13.1% vs. 27% respectively; HR 2.1731; 95% CI 1.2534, 3.764; p = 0.006). After Adjusting for patient or tumor characteristics, elevated Ki-67 remained significantly correlated with recurrence. Grade 4 Simpson resection was noted in 71 (23.7%) of patients and it was associated with a significantly increased risk of recurrence (HR 2.56; 95% CI 1.41, 4.6364; p = 0.002). Conclusions WHO grade 1 meningiomas exhibit a significant rate of recurrence following resection. While Ki-67 is not part of the WHO grading criteria of meningiomas, a value greater than 5% is an independent predictor for increased risk of local recurrence following surgical resection.