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Malignant progression of meningioma: A retrospective observational study
수막종의 악성 진행에 대한 후향적 관찰

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Authors
고은정
Advisor
김동규
Major
의과대학 의학과
Issue Date
2017-08
Publisher
서울대학교 대학원
Keywords
MeningiomaMalignant progressionAtypical meningiomaAnaplastic meningioma
Description
학위논문 (석사)-- 서울대학교 대학원 의과대학 의학과, 2017. 8. 김동규.
Abstract
Objective:
High-grade meningiomas have more aggressive behavior and poorer prognosis than benign meningiomas. High-grade meningioma may occur de novo or be transformed from a lower grade tumor rarely. We assessed clinical course, treatment outcome, and the factors affecting disease progression and survival of patients with transformed high-grade meningioma.
Methods:
Total 27 patients who were treated surgically first in our institution and showed a histological progression from a lower grade through follow-up were selected. We reviewed the patients medical records including demographic data, clinical histories, radiologic evaluations and pathologic reports. We assessed the timing and course of recurrence and malignant progression, treatment modalities, outpatient follow-up, and survival. Prognostic factor analysis for malignant progression and post-progression survival was performed.
Results:
Thirteen patients were females, and 14 were males. The mean age at the first diagnosis was 46.1 years. The most common presentations were hemiparesis and visual disturbance. The most prevalent locations were parasagittal/falx area and skull base. Twelve patients received gross total resection and 15 patients received subtotal resection. Sixteen patients were with atypical meningioma transformed from benign. Six patients were with anaplastic meningioma transformed from benign. Four patients were with anaplastic meningioma transformed from atypical. One patient was diagnosed with anaplastic meningioma transformed from benign through atypical. Twelve patients underwent adjuvant treatment in between the first operation and malignant progression. Seventeen patients got adjuvant treatment after malignant progression.
Initial tumor pathology (benign vs. atypical), age (under vs. over 50 years), and tumor location (convexity vs. non-convexity) were predictive for progression-free survival. Tumor pathology (atypical vs. anaplastic) and age (under vs. over 50 years) were prognostic for post-progression survival.
Conclusion:
Higher-grade tumor, old age and non-convexity location were related to shorter progression-free survival. Anaplastic pathology and old age might predict unfavorable outcome after progression. The prognosis of transformed meningioma might be poorer than that of de novo meningioma.
Language
English
URI
https://hdl.handle.net/10371/137988
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Theses (Master's Degree_의학과)
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