Skip to main content

Advertisement

SpringerLink
Log in

Patterns of relapse and growth kinetics of surgery- and radiation-refractory meningiomas

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Patients with surgery- and radiation-refractory meningiomas have a poor outcome. Due to our lack of knowledge concerning multi-recurrent meningioma natural history, their clinical course is poorly defined. This retrospective study aims at defining patterns of relapse in order to help in the definition of response criteria in future clinical trials. We performed a retrospective review of surgery- and radiotherapy-refractory meningioma cases with interpretable radiological follow-up treated in our department. Tumor volumes were measured on 3D T1 Gadolinium volumetric sequences using a semi-automated algorithm for tumor segmentation. Twenty nine patients with multi-treated meningioma (11 WHO Grade II, 5 de novo WHO Grade III and 13 transformed WHO Grade III), were evaluated. Median PFS was 16 months for patients with Grade II meningiomas. In patients with Grade III meningiomas, the de novo subgroup had a median PFS of 4 months compared with 7 months in patients with malignant transformation. Volumetric analysis of tumor growth concerned 95 tumor nodules in 50 relapses. The mean growth rate of tumor nodules was 10.4 cm3/year (95 % CI 7.3–14.8 cm3/year). Three patterns of tumor growth were described: “classical” for 9 (31 %) patients, “local multi-nodular” for 6 (21 %) patients and “multi-nodular metastatic” for the last 14 (48 %) patients. Considering all tumor nodules, median time to tumor progression (TTP) was 3.7 months. Progressing tumors represent the most frequent histological subgroup of surgery and radiation-refractory meningiomas while tumors with multi-nodular metastatic dissemination are the prominent radiological pattern of progression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ostrom QT, Gittleman H, Farah P, Ondracek A, Chen Y, Wolinsky Y, Stroup NE, Kruchko C, Barnholtz-Sloan JS (2013) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro Oncol 15(Suppl 2):ii1–ii56

    Article  PubMed Central  PubMed  Google Scholar 

  2. Durand A, Labrousse F, Jouvet A, Bauchet L, Kalamarides M, Menei P, Deruty R, Moreau JJ, Fevre-Montange M, Guyotat J (2009) WHO grade II and III meningiomas: a study of prognostic factors. J Neurooncol 95(3):367–375

    Article  PubMed  Google Scholar 

  3. Aghi MK, Carter BS, Cosgrove GR, Ojemann RG, Amin-Hanjani S, Martuza RL, Curry WT Jr, Barker FG (2009) Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation. Neurosurgery 64(1):56–60 discussion 60

    Article  PubMed  Google Scholar 

  4. Sughrue ME, Sanai N, Shangari G, Parsa AT, Berger MS, McDermott MW (2010) Outcome and survival following primary and repeat surgery for World Health Organization Grade III meningiomas. J Neurosurg 113(2):202–209

    Article  PubMed  Google Scholar 

  5. Hanft S, Canoll P, Bruce JN (2010) A review of malignant meningiomas: diagnosis, characteristics, and treatment. J Neurooncol 99(3):433–443

    Article  CAS  PubMed  Google Scholar 

  6. Goutagny S, Yang HW, Zucman-Rossi J, Chan J, Dreyfuss JM, Park PJ, Black PM, Giovannini M, Carroll RS, Kalamarides M (2010) Genomic profiling reveals alternative genetic pathways of meningioma malignant progression dependent on the underlying NF2 status. Clin Cancer Res 16(16):4155–4164

    Article  CAS  PubMed  Google Scholar 

  7. Al-Mefty O, Kadri PA, Pravdenkova S, Sawyer JR, Stangeby C, Husain M (2004) Malignant progression in meningioma: documentation of a series and analysis of cytogenetic findings. J Neurosurg 101(2):210–218

    Article  PubMed  Google Scholar 

  8. Krayenbuhl N, Pravdenkova S, Al-Mefty O (2007) De novo versus transformed atypical and anaplastic meningiomas: comparisons of clinical course, cytogenetics, cytokinetics, and outcome. Neurosurgery 61(3):495–503 discussion 503–494

    Article  PubMed  Google Scholar 

  9. Kaley T, Barani I, Chamberlain M, McDermott M, Panageas K, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P (2014) Historical benchmarks for medical therapy trials in surgery- and radiation-refractory meningioma: a RANO review. Neuro Oncol 16(6):829–840

    Article  PubMed  Google Scholar 

  10. Clarencon F, Maizeroi-Eugene F, Bresson D, Maingreaud F, Sourour N, Couquet C, Ayoub D, Chiras J, Yardin C, Mounayer C (2015) Elaboration of a semi-automated algorithm for brain arteriovenous malformation segmentation: initial results. Eur Radiol 25(2):436–443

    Article  PubMed  Google Scholar 

  11. Plotkin SR, Halpin C, Blakeley JO, Slattery WH 3rd, Welling DB, Chang SM, Loeffler JS, Harris GJ, Sorensen AG, McKenna MJ, Barker FG 2nd (2009) Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma. J Neurooncol 93(1):61–77

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Wen PY, Yung WK, Lamborn KR, Norden AD, Cloughesy TF, Abrey LE, Fine HA, Chang SM, Robins HI, Fink K, Deangelis LM, Mehta M, Di Tomaso E, Drappatz J, Kesari S, Ligon KL, Aldape K, Jain RK, Stiles CD, Egorin MJ, Prados MD (2009) Phase II study of imatinib mesylate for recurrent meningiomas (North American Brain Tumor Consortium study 01-08). Neuro Oncol 11(6):853–860

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Chamberlain MC (2011) Hydroxyurea for recurrent surgery and radiation refractory high-grade meningioma. J Neurooncol 107(2):315–321

    Article  PubMed  Google Scholar 

  14. Chamberlain MC (2012) The role of chemotherapy and targeted therapy in the treatment of intracranial meningioma. Curr Opin Oncol 24(6):666–671

    Article  CAS  PubMed  Google Scholar 

  15. Kaley TJ, Wen P, Schiff D, Ligon K, Haidar S, Karimi S, Lassman AB, Nolan CP, DeAngelis LM, Gavrilovic I, Norden A, Drappatz J, Lee EQ, Purow B, Plotkin SR, Batchelor T, Abrey LE, Omuro A (2014) Phase II trial of sunitinib for recurrent and progressive atypical and anaplastic meningioma. Neuro Oncol 17(1):116–121

    Article  PubMed  Google Scholar 

  16. Macdonald DR, Cascino TL, Schold SC Jr, Cairncross JG (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8(7):1277–1280

    CAS  PubMed  Google Scholar 

  17. Erasmus JJ, Gladish GW, Broemeling L, Sabloff BS, Truong MT, Herbst RS, Munden RF (2003) Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: implications for assessment of tumor response. J Clin Oncol 21(13):2574–2582

    Article  PubMed  Google Scholar 

  18. Harris GJ, Plotkin SR, Maccollin M, Bhat S, Urban T, Lev MH, Slattery WH (2008) Three-dimensional volumetrics for tracking vestibular schwannoma growth in neurofibromatosis type II. Neurosurgery 62(6):1314–1319 discussion 1319–1320

    Article  PubMed  Google Scholar 

  19. Cai W, Kassarjian A, Bredella MA, Harris GJ, Yoshida H, Mautner VF, Wenzel R, Plotkin SR (2009) Tumor burden in patients with neurofibromatosis types 1 and 2 and schwannomatosis: determination on whole-body MR images. Radiology 250(3):665–673

    Article  PubMed  Google Scholar 

  20. Weizman L, Sira LB, Joskowicz L, Rubin DL, Yeom KW, Constantini S, Shofty B, Bashat DB (2014) Semiautomatic segmentation and follow-up of multicomponent low-grade tumors in longitudinal brain MRI studies. Med Phys 41(5):052303

    Article  PubMed Central  PubMed  Google Scholar 

  21. Dinkel J, Khalilzadeh O, Hintze C, Fabel M, Puderbach M, Eichinger M, Schlemmer HP, Thorn M, Heussel CP, Thomas M, Kauczor HU, Biederer J (2013) Inter-observer reproducibility of semi-automatic tumor diameter measurement and volumetric analysis in patients with lung cancer. Lung Cancer 82(1):76–82

    Article  CAS  PubMed  Google Scholar 

  22. Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW (2008) Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J Neurol Neurosurg Psychiatry 79(5):574–580

    Article  PubMed  Google Scholar 

  23. Cornelius JF, Slotty PJ, Steiger HJ, Hanggi D, Polivka M, George B (2013) Malignant potential of skull base versus non-skull base meningiomas: clinical series of 1663 cases. Acta Neurochir (Wien) 155(3):407–413

    Article  Google Scholar 

  24. McGovern SL, Aldape KD, Munsell MF, Mahajan A, DeMonte F, Woo SY (2009) A comparison of World Health Organization tumor grades at recurrence in patients with non-skull base and skull base meningiomas. J Neurosurg 112(5):925–933

    Article  Google Scholar 

  25. Chamberlain MC, Glantz MJ (2005) Cerebrospinal fluid-disseminated meningioma. Cancer 103(7):1427–1430

    Article  PubMed  Google Scholar 

  26. Nordqvist AC, Smurawa H, Mathiesen T (2001) Expression of matrix metalloproteinases 2 and 9 in meningiomas associated with different degrees of brain invasiveness and edema. J Neurosurg 95(5):839–844

    Article  CAS  PubMed  Google Scholar 

  27. Jalali S, Singh S, Agnihotri S, Wataya T, Salehi F, Burrell K, Navab R, Croul S, Aldape K, Zadeh G (2014) A role for matrix remodeling proteins in invasive and malignant meningiomas. Neuropathol Appl Neurobiol. doi:10.1016/j.cell.2014.09.021

    Google Scholar 

  28. Nagashima G, Fujimoto T, Suzuki R, Asai J, Itokawa H, Noda M (2006) Dural invasion of meningioma: a histological and immunohistochemical study. Brain Tumor Pathol 23(1):13–17

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Franck Maizeroi-Eugène for his kind gift of the Segmentix® plugin and Dr Pierre Ruffat for his help regarding statistical methods.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Service de Neurochirurgie, AP-HP, Hôpital Pitié Salpêtrière, 47-83 bvd de l’Hôpital, 75013, Paris, France

    Matthieu Peyre, Marc Zanello, Anne-Laure Boch, Laurent Capelle, Alexandre Carpentier, Stephane Clemenceau, Carine Karachi, Soledad Navarro, Aurelien Nouet, Vincent Reina, Charles-Ambroise Valery, Philippe Cornu & Michel Kalamarides

  2. Institut du Cerveau et de la Moelle Epinière, INSERM U1127 CNRS UMR 7225, Paris, France

    Matthieu Peyre, Karima Mokhtari, Marc Sanson & Michel Kalamarides

  3. Université Paris 6 - Pierre et Marie Curie, Paris, France

    Matthieu Peyre, Alexandre Carpentier, Carine Karachi, Vincent Reina, Marc Sanson, Philippe Cornu & Michel Kalamarides

  4. Department of Neuropathology, AP-HP, Hôpital de La Pitié Salpêtrière, Paris, France

    Karima Mokhtari

  5. Department of Neuro-Oncology, AP-HP, Hôpital de La Pitié Salpêtrière, Paris, France

    Marc Sanson

Authors
  1. Matthieu Peyre
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc Zanello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karima Mokhtari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne-Laure Boch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laurent Capelle
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alexandre Carpentier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephane Clemenceau
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carine Karachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Soledad Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Aurelien Nouet
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Vincent Reina
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Charles-Ambroise Valery
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Marc Sanson
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Philippe Cornu
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Michel Kalamarides
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michel Kalamarides.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peyre, M., Zanello, M., Mokhtari, K. et al. Patterns of relapse and growth kinetics of surgery- and radiation-refractory meningiomas. J Neurooncol 123, 151–160 (2015). https://doi.org/10.1007/s11060-015-1778-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-015-1778-1

Keywords

Search

Navigation