{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:31:18Z","timestamp":1790742678025,"version":"4.1.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Despite an increased understanding of the biology of malignant meningioma tumor progression, there is a paucity of published clinical data on factors affecting outcomes following treatment for these lesions. The authors present the largest case series to date dealing with these tumors, providing analysis of 63 patients.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors identified all patients undergoing resection of WHO Grade III tumors at their institution over a 16-year period. They analyzed clinical data from these patients, and performed Kaplan-Meier and Cox regression analyses to determine the impact of different clinical characteristics and different treatment modalities on survival following initial and repeat surgery for these lesions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Sixty-three patients met inclusion criteria and were analyzed further. The median clinical follow-up time was 5 years (range 1\u201322 years). The 2-, 5-, and 10-year overall survival rates following initial operation were 82, 61, and 40%, respectively. Kaplan-Meier analysis demonstrated a marked survival benefit with repeat operation (53 vs 25 months, p = 0.02). Interestingly, patients treated with near-total resection experienced improved overall survival when compared with patients treated with gross-total resection at initial (p = 0.035) and repeat operations (p = 0.005). Twelve (19%) of 63 patients experienced significant neurological morbidity referable to the resection of their tumors.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Surgery is an effective treatment for WHO Grade III meningiomas at presentation and recurrence; however, aggressive attempts to achieve gross-total resection can be associated with significant neurological risk.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.1.jns091114","type":"journal-article","created":{"date-parts":[[2010,3,12]],"date-time":"2010-03-12T13:47:48Z","timestamp":1268401668000},"page":"202-209","source":"Crossref","is-referenced-by-count":128,"title":["Outcome and survival following primary and repeat surgery for World Health Organization Grade III meningiomas"],"prefix":"10.3171","volume":"113","author":[{"given":"Michael E.","family":"Sughrue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Sanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopal","family":"Shangari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Parsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchel S.","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns091114","series-title":"Neurosurgery","first-page":"56","article-title":"Long-term recurrence rates of atypical meningiomas after gross total resection with or without postoperative adjuvant radiation","volume":"64","author":"Aghi","year":"2009"},{"key":"b2-jns091114","series-title":"Brain Pathol","first-page":"172","article-title":"An orthotopic skull base model of malignant meningioma","volume":"18","author":"Baia","year":"2008"},{"key":"b3-jns091114","series-title":"Neoplasia","first-page":"604","article-title":"Notch activation is associated with tetraploidy and enhanced chromosomal instability in meningiomas","volume":"10","author":"Baia","year":"2008"},{"key":"b4-jns091114","series-title":"J Neurooncol","first-page":"151","article-title":"Adjuvant enoxaparin therapy may decrease the incidence of postoperative thrombotic events though does not increase the incidence of postoperative intracranial hemorrhage in patients with meningiomas","volume":"93","author":"Cage","year":"2009"},{"key":"b5-jns091114","series-title":"Mol Cancer","first-page":"64","article-title":"Molecular signatures define two main classes of meningiomas","volume":"6","author":"Carvalho","year":"2007"},{"key":"b6-jns091114","series-title":"Neurology","first-page":"969","article-title":"Recurrent meningioma: salvage therapy with long-acting somatostatin analogue","volume":"69","author":"Chamberlain","year":"2007"},{"key":"b7-jns091114","series-title":"J Neurooncol","first-page":"271","article-title":"Salvage chemotherapy with CPT-11 for recurrent meningioma","volume":"78","author":"Chamberlain","year":"2006"},{"key":"b8-jns091114","series-title":"Neurology","first-page":"1210","article-title":"Temozolomide for treatment-resistant recurrent meningioma","volume":"62","author":"Chamberlain","year":"2004"},{"key":"b9-jns091114","series-title":"Neurosurgery","first-page":"1231","article-title":"Delayed surgical resection reduces intraoperative blood loss for embolized meningiomas","volume":"50","author":"Chun","year":"2002"},{"key":"b10-jns091114","series-title":"J Neurosurg","first-page":"455","article-title":"Irinotecan: a potential new chemotherapeutic agent for atypical or malignant meningiomas","volume":"106","author":"Gupta","year":"2007"},{"key":"b11-jns091114","series-title":"Applied Logistic Regression","author":"Hosmer","year":"2000"},{"key":"b12-jns091114","series-title":"Surg Neurol","first-page":"461","article-title":"Seemingly complete removal of histologically benign intracranial meningioma: late recurrence rate and factors predicting recurrence in 657 patients. A multivariate analysis","volume":"26","author":"J\u00e4\u00e4skel\u00e4inen","year":"1986"},{"issue":"5","key":"b13-jns091114","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Surgery and radiotherapy: complementary tools in the management of benign intracranial tumors","volume":"24","author":"Johnson","year":"2008"},{"key":"b14-jns091114","series-title":"WHO Classification of Tumours of the Central Nervous System","year":"2007"},{"key":"b15-jns091114","series-title":"J Neurosurg","first-page":"846","article-title":"Stereotactic radiation treatment for recurrent nonbenign meningiomas","volume":"106","author":"Mattozo","year":"2007"},{"key":"b16-jns091114","series-title":"J Neurooncol","first-page":"299","article-title":"Microsurgery plus whole brain irradiation versus Gamma Knife surgery alone for treatment of single metastases to the brain: a randomized controlled multicentre phase III trial","volume":"87","author":"Muacevic","year":"2008"},{"key":"b17-jns091114","series-title":"J Neurosurg","first-page":"398","article-title":"Malignant transformation-related genes in meningiomas: allelic loss on 1p36 and methylation status of p73 and RASSF1A","volume":"107","author":"Nakane","year":"2007"},{"issue":"Suppl 3","key":"b18-jns091114","series-title":"J Neurosurg","first-page":"62","article-title":"Radiosurgery for malignant meningioma: results in 22 patients","volume":"93","author":"Ojemann","year":"2000"},{"key":"b19-jns091114","series-title":"J Neurosurg","article-title":"Risk profile associated with convexity meningioma resection in the modern neurosurgical era. Clinical article","author":"Sanai"},{"key":"b20-jns091114","series-title":"Neurosurgery","first-page":"1029","article-title":"Meningioma radiosurgery: tumor control, outcomes, and complications among 190 consecutive patients","volume":"49","author":"Stafford","year":"2001"},{"key":"b21-jns091114","series-title":"Aust N Z J Surg","first-page":"144","article-title":"Factors affecting morbidity and mortality following surgical intervention in patients with intracranial meningioma","volume":"66","author":"Turgut","year":"1996"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/2\/article-p202.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/2\/article-p202.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/2\/article-p202.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T04:23:00Z","timestamp":1679890980000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/2\/article-p202.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2010,8]]},"references-count":21,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2010.1.jns091114","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,8]]}}}