{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:36:37Z","timestamp":1740166597022,"version":"3.37.3"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and Study Aims\/Object\u2003Despite the relevance of molecular criteria for brain tumor diagnosis and prognosis, meningioma grading is still solely based on histologic features. Atypical meningiomas (AMs; WHO grade II) display a great histologic heterogeneity and individual courses of disease can differ significantly. This study aimed to identify clinically aggressive AMs that are prone to early recurrence after gross total resection (GTR) by assessing a specific histologic score.<\/jats:p><jats:p>\n          Patients and Methods\u2003A retrospective analysis of 28 consecutive patients (17 females and 11 males; mean age of 62 years [range: 35\u201388 years]) treated in our institution between January 2006 and December 2015 was performed. Basic demographic and clinical characteristics were assessed. A scoring scale was designed to address the histologic diversity by summing up the individual histologic features in every tumor sample. According to that, points were awarded as follows: major AM defining criterion (3 points) and minor criterion (1 point).<\/jats:p><jats:p>\n          Results\u2003The subclassification based on our specific histologic score revealed no significant difference in frequency of one (46.4%) or two (42.9%) AM defining features; three criteria were less frequently seen (10.7%). Mean follow-up was 61.89\u2009\u00b1\u20099.03 months. Local recurrence occurred in 35.7% after a mean time of 37.4\u2009\u00b1\u200922.6 months after primary surgery. Age\u2009&gt;\u200960 years was significantly associated with a shorter progression-free survival (PFS). There was a trend toward shorter PFS with increasing scores, tantamount with the presence of several AM defining histologic criteria in one sample. No tumor relapse was seen when diagnosis was based only on minor criteria.<\/jats:p><jats:p>\n          Conclusion\u2003AMs display a histologic diversity. There is a trend toward shorter PFS with increasing numbers of AM defining histologic features. The inclusion of this score in the decision algorithm regarding further treatment for patients &gt;60 years after GTR might be helpful and should be evaluated in further studies.<\/jats:p>","DOI":"10.1055\/s-0040-1720987","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T23:35:39Z","timestamp":1618270539000},"page":"417-423","source":"Crossref","is-referenced-by-count":1,"title":["The 2016 Edition of the WHO Classification of Primary Brain Tumors: Applicable to Assess Individual Risk of Recurrence in Atypical Meningioma? A Single-Center Experience"],"prefix":"10.1055","volume":"82","author":[{"given":"Meike","family":"Unteroberd\u00f6rster","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"},{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvin","family":"Darkwah Oppong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramazan","family":"Jabbarli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolai El","family":"Hindy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"},{"name":"Werne Spine Center, Hospital L\u00fcnen\/Werne GmbH \u2013 St. Christophorus Hospital, Werne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-3503","authenticated-orcid":false,"given":"Karsten H.","family":"Wrede","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Sure","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Pierscianek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"D N Louis","year":"2016","journal-title":"Acta Neuropathol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0090-3019(03)00488-9","article-title":"Unmasking the secrets of meningioma: a slow but rewarding journey","volume":"61","author":"A Perry","year":"2004","journal-title":"Surg Neurol"},{"issue":"24","key":"ref3","doi-asserted-by":"crossref","first-page":"4376","DOI":"10.1002\/cncr.29639","article-title":"Extent of resection and overall survival for patients with atypical and malignant meningioma","volume":"121","author":"A A Aizer","year":"2015","journal-title":"Cancer"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3171\/2014.7.JNS131644","article-title":"Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review","volume":"122","author":"L Rogers","year":"2015","journal-title":"J Neurosurg"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0165-4608(98)00209-X","article-title":"Allelic losses at 1p, 9q, 10q, 14q, and 22q in the progression of aggressive meningiomas and undifferentiated meningeal sarcomas","volume":"110","author":"K Lamszus","year":"1999","journal-title":"Cancer Genet Cytogenet"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0165-4608(03)00279-6","article-title":"Association of loss of 1p and alterations of chromosome 14 in meningioma progression","volume":"148","author":"C Lopez-Gines","year":"2004","journal-title":"Cancer Genet Cytogenet"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s11060-018-2912-7","article-title":"TERT promoter mutation is associated with worse prognosis in WHO grade II and III meningiomas","volume":"139","author":"A Biczok","year":"2018","journal-title":"J Neurooncol"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S1470-2045(17)30155-9","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"F Sahm","year":"2017","journal-title":"Lancet Oncol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1136\/jnnp.20.1.22","article-title":"The recurrence of intracranial meningiomas after surgical treatment","volume":"20","author":"D Simpson","year":"1957","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3340\/jkns.2017.0303.008","article-title":"Prognostic factors of atypical meningioma: overall survival rate and progression free survival rate","volume":"60","author":"J H Lee","year":"2017","journal-title":"J Korean Neurosurg Soc"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s11060-017-2634-2","article-title":"Atypical meningioma: progression-free survival in 161 cases treated at our institution with surgery versus surgery and radiotherapy","volume":"136","author":"W Masalha","year":"2018","journal-title":"J Neurooncol"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.adro.2016.03.001","article-title":"An analysis of prognostic factors associated with recurrence in the treatment of atypical meningiomas","volume":"1","author":"C Fernandez","year":"2016","journal-title":"Adv Radiat Oncol"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.4103\/0973-1482.148708","article-title":"Atypical meningioma: randomized trials are required to resolve contradictory retrospective results regarding the role of adjuvant radiotherapy","volume":"11","author":"H Yoon","year":"2015","journal-title":"J Cancer Res Ther"},{"issue":"08","key":"ref14","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s00701-014-2156-z","article-title":"Long-term survival analysis of atypical meningiomas: survival rates, prognostic factors, operative and radiotherapy treatment","volume":"156","author":"S Hammouche","year":"2014","journal-title":"Acta Neurochir (Wien)"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1007\/s00701-018-3593-x","article-title":"Predictors of early progression of surgically treated atypical meningiomas","volume":"160","author":"K P Budohoski","year":"2018","journal-title":"Acta Neurochir (Wien)"},{"issue":"09","key":"ref16","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1007\/s00701-016-2900-7","article-title":"A study of prognostic factors in 45 cases of atypical meningioma","volume":"158","author":"T Endo","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s11060-016-2181-2","article-title":"WHO grade II meningioma: a retrospective study for outcome and prognostic factor assessment","volume":"129","author":"C Champeaux","year":"2016","journal-title":"J Neurooncol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1038\/s41525-017-0023-6","article-title":"Erratum: genomic landscape of high-grade meningiomas","volume":"2","author":"W L Bi","year":"2017","journal-title":"NPJ Genom Med"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1038\/ng0294-180","article-title":"Evidence for the complete inactivation of the NF2 gene in the majority of sporadic meningiomas","volume":"6","author":"M H Ruttledge","year":"1994","journal-title":"Nat Genet"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"e248","DOI":"10.1016\/j.wneu.2019.01.056","article-title":"Atypical meningiomas: histologic and clinical factors associated with recurrence","volume":"125","author":"A Ros-Sanjuan","year":"2019","journal-title":"World Neurosurg"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"e1275","DOI":"10.1016\/j.wneu.2018.11.032","article-title":"Treatment protocol, long-term follow-up, and predictors of mortality in 302 cases of atypical meningioma","volume":"122","author":"H Li","year":"2019","journal-title":"World Neurosurg"},{"issue":"12","key":"ref22","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1007\/s00701-019-04073-2","article-title":"Risk factors associated with postoperative recurrence in atypical intracranial meningioma: analysis of 263 cases at a single neurosurgical centre","volume":"161","author":"F Wang","year":"2019","journal-title":"Acta Neurochir (Wien)"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.neuchi.2017.03.004","article-title":"Atypical meningioma. A study on recurrence and disease-specific survival","volume":"63","author":"C Champeaux","year":"2017","journal-title":"Neurochirurgie"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.wneu.2015.05.032","article-title":"Treatment response and prognosis after recurrence of atypical meningiomas","volume":"84","author":"X Cao","year":"2015","journal-title":"World Neurosurg"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.wneu.2017.08.057","article-title":"Progression-free survival and factors associated with postoperative recurrence in 126 patients with atypical intracranial meningioma","volume":"107","author":"L Phonwijit","year":"2017","journal-title":"World Neurosurg"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1227\/01.NEU.0000330399.55586.63","article-title":"Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation","volume":"64","author":"M K Aghi","year":"2009","journal-title":"Neurosurgery"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1590\/0004-282X20150106","article-title":"Atypical and anaplastic meningiomas in a public hospital in S\u00e3o Paulo State, Brazil","volume":"73","author":"B O Colli","year":"2015","journal-title":"Arq Neuropsiquiatr"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s11060-019-03382-x","article-title":"Impact of postoperative radiotherapy on recurrence of primary intracranial atypical meningiomas","volume":"146","author":"N Keric","year":"2020","journal-title":"J Neurooncol"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"679","DOI":"10.3171\/2012.7.JNS112113","article-title":"The role of radiotherapy following gross-total resection of atypical meningiomas","volume":"117","author":"R J Komotar","year":"2012","journal-title":"J Neurosurg"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.wneu.2016.01.055","article-title":"World Health Organization grade II meningioma: a 10-year retrospective study for recurrence and prognostic factor assessment","volume":"89","author":"C Champeaux","year":"2016","journal-title":"World Neurosurg"},{"issue":"11","key":"ref31","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1093\/neuonc\/nou098","article-title":"Adjuvant radiation therapy, local recurrence, and the need for salvage therapy in atypical meningioma","volume":"16","author":"A A Aizer","year":"2014","journal-title":"Neuro-oncol"},{"issue":"05","key":"ref32","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.wneu.2014.12.037","article-title":"The role of adjuvant radiotherapy after gross total resection of atypical meningiomas","volume":"83","author":"S Hasan","year":"2015","journal-title":"World Neurosurg"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"e1153","DOI":"10.1016\/j.wneu.2018.11.006","article-title":"Long-term outcomes of newly-diagnosed resected atypical meningiomas and the role of adjuvant radiotherapy (ART)","volume":"122","author":"M Zhi","year":"2019","journal-title":"World Neurosurg"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.wneu.2017.04.095","article-title":"Revisiting adjuvant radiotherapy after gross total resection of World Health Organization grade II meningioma","volume":"103","author":"C S Graffeo","year":"2017","journal-title":"World Neurosurg"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1227\/NEU.0000000000000461","article-title":"Management of atypical cranial meningiomas, part 1: predictors of recurrence and the role of adjuvant radiation after gross total resection","volume":"75","author":"S Q Sun","year":"2014","journal-title":"Neurosurgery"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jocn.2017.08.023","article-title":"Early or late radiotherapy following gross or subtotal resection for atypical meningiomas: clinical outcomes and local control","volume":"46","author":"A Dohm","year":"2017","journal-title":"J Clin Neurosci"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jocn.2015.09.021","article-title":"Early adjuvant radiotherapy in the treatment of atypical meningioma","volume":"28","author":"M D Jenkinson","year":"2016","journal-title":"J Clin Neurosci"},{"issue":"04","key":"ref38","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1002\/cncr.31088","article-title":"Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma","volume":"124","author":"N R Rydzewski","year":"2018","journal-title":"Cancer"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"e148","DOI":"10.1016\/j.wneu.2019.04.069","article-title":"Preoperative and histological predictors of recurrence and survival in atypical meningioma after initial gross total resection","volume":"128","author":"J Loewenstern","year":"2019","journal-title":"World Neurosurg"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3171\/2017.9.JNS171609","article-title":"Histopathological features predictive of local control of atypical meningioma after surgery and adjuvant radiotherapy","volume":"130","author":"W C Chen","year":"2018","journal-title":"J Neurosurg"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.3171\/2016.11.JNS16913","article-title":"Histopathological prognostic factors of recurrence following definitive therapy for atypical and malignant meningiomas","volume":"128","author":"D Kim","year":"2018","journal-title":"J Neurosurg"},{"issue":"03","key":"ref42","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1007\/s10014-018-0318-z","article-title":"Histopathological features to define atypical meningioma: what does really matter for prognosis?","volume":"35","author":"V Barresi","year":"2018","journal-title":"Brain Tumor Pathol"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1720987.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T22:36:42Z","timestamp":1629326202000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1720987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,12]]},"references-count":42,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2021,8,18]]},"published-print":{"date-parts":[[2021,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1720987","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"type":"print","value":"2193-6315"},{"type":"electronic","value":"2193-6323"}],"subject":[],"published":{"date-parts":[[2021,4,12]]}}}