Male sex and presence of preoperative symptoms are associated with early recurrence of WHO grade I meningiomas after surgical resection: analysis from the nationwide Brain Tumor Registry of Japan
Male sex and presence of preoperative symptoms are associated with early recurrence of WHO grade I meningiomas after surgical resection: analysis from the nationwide Brain Tumor Registry of Japan
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DOI：
10.1007/s10143-022-01907-z
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发表时间：
2023-12-09
影响因子：
2.8
通讯作者：
Narita，Yoshitaka
中科院分区：
文献类型：
--
作者：
Oya，Soichi;Ikawa，Fusao;Narita，Yoshitaka
本研究旨在使用日本脑肿瘤登记（BTRJ）数据库评估WHO I级颅内脑膜瘤复发的风险因素。我们提取了2001年至2008年间仅通过手术切除治疗的4641例颅内WHO I级脑膜瘤患者的数据。我们进行了完整的数据分析（n= 3690）和多重插补分析（n= 4641），以调整肿瘤大小的缺失数据。评估了年龄、性别、大小、切除范围、位置和术前症状等因素对PFS的影响。完整数据集的单变量分析显示，年龄不影响PFS;然而，男性（p< 0.001）、肿瘤大小≥ 30 mm（p< 0.001）、切除程度低、肿瘤位于颅底（p< 0.001）和术前症状的存在（p< 0.001）是PFS显著缩短的危险因素。多变量分析表明，男性（p< 0.001）和术前症状（p= 0.027）是PFS较短以及肿瘤大小较大（p< 0.001）和非大体全切除（p< 0.001）的独立风险因素。这些结果在插补数据集中得到证实。虽然大多数以前的大型全国性脑膜瘤研究已经评估了总生存率，但无进展生存率尚未得到彻底检查。这项研究表明，即使是组织学上良性的脑膜瘤，术后行为也可能存在性别差异。这一观察结果可能为理解脑膜瘤细胞增殖的机制提供线索。
This study aimed to assess the risk factors for the recurrence of WHO grade I intracranial meningiomas using the Brain Tumor Registry of Japan (BTRJ) database. We extracted the data of 4641 patients with intracranial WHO grade I meningiomas treated only by surgical resection between 2001 and 2008. We conducted complete data analysis (n= 3690) and multiple imputation analysis (n= 4641) to adjust for missing data on tumor size. The influence of factors including age, sex, size, extent of resection, location, and preoperative symptoms on PFS was assessed. Univariate analyses of the complete data set showed that age did not affect PFS; however, male sex (p< 0.001), tumor size ≥ 30 mm (p< 0.001), low extent of resection, tumor location at the skull base (p< 0.001), and the presence of preoperative symptoms (p< 0.001) were risk factors for a significantly shorter PFS. Multivariate analysis demonstrated that male sex (p< 0.001) and presence of preoperative symptoms (p= 0.027) were independent risk factors for shorter PFS alongside large tumor size (p< 0.001) and non-gross total resection (p< 0.001). These results were confirmed for the imputed dataset. While most previous large nationwide studies of meningiomas have evaluated overall survival, progression-free survival has yet to be thoroughly examined. This study suggests that even histologically benign meningiomas may have a sex difference in postoperative behavior. This observation may provide clues to understanding the mechanism of meningioma cell proliferation.