{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:19:58Z","timestamp":1789147198003,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropathology Appl Neurobio"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Brain invasion (BI) was firstly defined as a single criterion of atypia in otherwise benign meningiomas in the revised fourth edition of 2016 WHO classification of brain tumours after being previously inconsistently addressed. However, recent studies have raised doubts about the prognostic significance of BI in otherwise benign meningiomas. In our study, we investigate the reproducibility of such a prognostic effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified two cohorts one consisting of 483 patients with meningioma WHO grade I (M\u00b0I) or atypical meningioma WHO grade II (M\u00b0II) from Hannover Medical School and the other including atypical meningiomas defined according to the classical WHO criteria (M\u00b0IIb) from the University Hospital Heidelberg. Follow\u2010up data with a median observation time of 38.2\u00a0months were available from 308 cases. These included 243 M\u00b0I and 65 M\u00b0II patients with the latter group consisting of 25 patients with otherwise benign meningiomas with BI (M\u00b0IIa) and 40 with M\u00b0IIb.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant difference of progression\u2010free interval (PFI) was found between patients with M\u00b0I and M\u00b0II, M\u00b0I and M\u00b0IIa and those with M\u00b0I and M\u00b0IIb of both cohorts and each separately. However, PFI of M\u00b0IIa and M\u00b0IIb patients showed no significant difference. In the multivariate regression analysis adjusted for M\u00b0I\/M\u00b0IIa versus M\u00b0IIb, sex, age, extent of resection and tumour location, BI exhibited the strongest risk of relapse (Hazard ratio: 4.95) serving as an independent predictor of PFI (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results clearly support the definition of BI as a single criterion of atypia in WHO classification of 2016.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nan.12700","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T02:28:01Z","timestamp":1611887281000},"page":"724-735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The prognostic significance of clinicopathological features in meningiomas: Microscopic brain invasion can predict patient outcome in otherwise benign 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