Improved correlation of the neuropathologic classification according to adapted World Health Organization classification and outcome after radiotherapy in patients with atypical and anaplastic meningiomas

Purpose - To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. - Patients and Methods - Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated wit...

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Hauptverfasser: Combs, Stephanie (VerfasserIn) , Schulz-Ertner, Daniela (VerfasserIn) , Debus, Jürgen (VerfasserIn) , Deimling, Andreas von (VerfasserIn) , Hartmann, Christian (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2011
In: International journal of radiation oncology, biology, physics
Year: 2011, Jahrgang: 81, Heft: 5, Pages: 1415-1421
ISSN:1879-355X
DOI:10.1016/j.ijrobp.2010.07.039
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ijrobp.2010.07.039
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0360301610009727
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Verfasserangaben:Stephanie E. Combs, Daniela Schulz-Ertner, Jürgen Debus, Andreas von Deimling, and Christian Hartmann

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520 |a Purpose - To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. - Patients and Methods - Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. - Results - All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups (p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant (p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups (p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups (p = .005). - Conclusion - The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the published data for future treatment decision-making remains difficult when the histologic diagnosis has not been based on the new improved classification system. 
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