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  • Atypical and Anaplastic Meningioma (AAM): Outcomes in a Population-Based Study

    Final Number:
    5

    Authors:
    Tomas Garzon-Muvdi MD MS; Wuyang Yang MD MS; Michael Lim MD; Henry Brem MD; Judy Huang MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Approximately 5% of meningiomas are atypical and anaplastic (AAM)(WHO II and III). AAM are aggressive tumors and are coupled to a poor prognosis and higher mortality caused by the tumor. We performed a population-based study to identify important factors that determine survival of patients with AAM.

    Methods: We used data from patients with AAM from the SEER dataset between 1973-2012. Basic demographics, size of the tumor, tumor location, and treatment variables were included for each patient. Provided with the relatively older population and benign disease course, we observed a significant portion of patients with unrelated death; therefore, a competing risk analysis was employed to account for unrelated deaths when delineating factors associated with cumulative incidence of tumor-related deaths, cumulative incidence of tumor-related death was computed for each factor in a multivariate competing risk regression model.

    Results: We identified 522 patients after applying inclusion and exclusion criteria. Mean age at diagnosis for all patients was 60.8 ± 15.7 years. Seventy-three percent of patients were white, 15.5% black, and 9.8% were Asian. More than half of the patients (53.8 %) were married. Mean tumor size was 48.2 ± 20.3 mm. The vast majority (94.8%) of tumors were supratentorial. Significant factors affecting survival of patients diagnosed with AAM were identified in a multivariate proportional competing risk regression analysis: older age (HR:1.03,CI=[1.01,1.04],p<0.001), infratentorial location (HR:2.81,CI=[1.20, 6.56],p=0.017), tumor size (HR 1.01, CI=[1.00, 1.02],p=0.032), and radiation treatment (HR:1.52, CI=[1.11,2.09], p=0.01).

    Conclusions: Older age, infratentorial location, tumor size, and radiation treatment were associated with tumor-related death of atypical meningioma.

    Patient Care: This population-based study examines atypical/malignant meningiomas, which is an extremely rare disease with unknown disease progression and management strategy. We found several factors associated with tumor-related death of these patients. In addition, we found that radiation provided no survival benefit in tumor-related death. This study may serve as the foundation of knowledge on this rare disease.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) To utilize large population-based datasets to improve understanding of the outcome of patients with atypical and anaplastic meningioma. 2) To identify variables that determine survival of atypical and anaplastic meningioma patients.

    References:

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