{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:29:37Z","timestamp":1791836977545,"version":"4.3.4"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>In 1957, Simpson published a seminal paper defining the risk factors for recurrence following surgical treatment of intracranial meningiomas. Given that Simpson's study was published more than 50 years ago, preceding image guidance technology and MR imaging, the authors reviewed their own experience with surgical treatment of Grade I meningiomas to determine if Simpson's grading scale is still relevant to modern neurosurgical practice.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>From this cohort, the authors evaluated all patients undergoing craniotomy for resection of a histologically proven WHO Grade I meningioma as their initial therapy. Clinical information was retrospectively reconstructed using patient medical records and radiological data. Recurrence analysis was performed using the Kaplan-Meier method.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The 5-year recurrence\/progression-free survival for all patients receiving a Simpson Grade I, II, III, or IV resection was 95, 85, 88, and 81%, respectively (p = not significant, log-rank test). Kaplan-Meier analysis revealed no significant difference in recurrence-free survival between patients receiving a Simpson Grade I, II, III, or IV resection. Analysis limited to meningiomas arising from the skull base (excluding the cavernous sinus) similarly found no significant benefit to Simpson Grade I or II resection, and the survival curves were nearly superimposed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this study of a cohort of patients undergoing surgery for WHO Grade I meningiomas, the authors demonstrate that the benefit of more aggressive attempts to resect the tumor with dura and underlying bone was negligible compared with simply removing the entire tumor, or even leaving small amounts of tumor attached to critical structures. The authors believe that these data reflect an evolution in the nature of meningioma surgery over the past 2 decades, and bring into question the relevance of using Simpson's grading system as the sole predictor of recurrence.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.3.jns091971","type":"journal-article","created":{"date-parts":[[2010,4,9]],"date-time":"2010-04-09T14:09:19Z","timestamp":1270822159000},"page":"1029-1035","source":"Crossref","is-referenced-by-count":222,"title":["The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomas"],"prefix":"10.3171","volume":"113","author":[{"given":"Michael E.","family":"Sughrue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari J.","family":"Kane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopal","family":"Shangari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Rutkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchel S.","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Parsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns091971","series-title":"J Neurosurg","first-page":"1053","article-title":"ABC Surgical Risk Scale for skull base meningioma: a new scoring system for predicting the extent of tumor removal and neurological outcome. 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A multivariate analysis","volume":"26","author":"J\u00e4\u00e4skel\u00e4inen","year":"1986"},{"key":"b9-jns091971","series-title":"Neurosurgery","first-page":"405","article-title":"Judicious resection and\/or radiosurgery for parasagittal meningiomas: outcomes from a multicenter review","volume":"43","author":"Kondziolka","year":"1998"},{"key":"b10-jns091971","series-title":"J Neurosurg","first-page":"44","article-title":"Long-term outcomes after meningioma radiosurgery: physician and patient perspectives","volume":"91","author":"Kondziolka","year":"1999"},{"key":"b11-jns091971","series-title":"J Neuroimaging","first-page":"177","article-title":"Neurosarcoidosis resembling meningioma: MRI characteristics and pathologic correlation","volume":"8","author":"Krejchi","year":"1998"},{"key":"b12-jns091971","series-title":"Neurosurgery","first-page":"221","article-title":"Proposed grading system to predict the extent of resection and outcomes for cranial base meningiomas","volume":"45","author":"Levine","year":"1999"},{"key":"b13-jns091971","series-title":"Bull Cancer","first-page":"E27","article-title":"Malignant meningiomas: a retrospective study of 22 cases","volume":"94","author":"Liu","year":"2007"},{"key":"b14-jns091971","series-title":"Clin Neuropathol","first-page":"29","article-title":"Local versus diffuse recurrences of meningiomas: factors correlated to the extent of the recurrence","volume":"27","author":"Maiuri","year":"2008"},{"key":"b15-jns091971","series-title":"Neurosurgery","first-page":"2","article-title":"Recurrence of cranial base meningiomas","volume":"39","author":"Mathiesen","year":"1996"},{"key":"b16-jns091971","series-title":"J Neurosurg","first-page":"18","article-title":"Meningioma: analysis of recurrence and progression following neurosurgical resection","volume":"62","author":"Mirimanoff","year":"1985"},{"key":"b17-jns091971","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"},{"key":"b18-jns091971","series-title":"Acta Neurochir (Wien)","first-page":"108","article-title":"Factors influencing meningioma recurrence rate","volume":"107","author":"Naumann","year":"1990"},{"key":"b19-jns091971","series-title":"Neurosurgery","first-page":"534","article-title":"Recurrence of olfactory groove meningiomas","volume":"53","author":"Obeid","year":"2003"},{"key":"b20-jns091971","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1000","article-title":"Stereotactic radiosurgery provides equivalent tumor control to Simpson Grade 1 resection for patients with small- to medium-size meningiomas","volume":"55","author":"Pollock","year":"2003"},{"key":"b21-jns091971","series-title":"Int J Radiat Oncol Biol Phys","first-page":"427","article-title":"Long-term experience with World Health Organization grade III (malignant) meningiomas at a single institution","volume":"74","author":"Rosenberg","year":"2009"},{"key":"b22-jns091971","series-title":"J Neurosurg","article-title":"Risk profile associated with convexity meningioma resection in the modern neurosurgical era. Clinical article","author":"Sanai"},{"key":"b23-jns091971","series-title":"J Neurol Neurosurg Psychiatry","first-page":"22","article-title":"The recurrence of intracranial meningiomas after surgical treatment","volume":"20","author":"Simpson","year":"1957"},{"key":"b24-jns091971","series-title":"Br J Neurosurg","first-page":"588","article-title":"Atypical meningiomas: WHO moved the goalposts?","volume":"21","author":"Smith","year":"2007"},{"key":"b25-jns091971","series-title":"Mayo Clin Proc","first-page":"936","article-title":"Primarily resected meningiomas: outcome and prognostic factors in 581 Mayo Clinic patients, 1978 through 1988","volume":"73","author":"Stafford","year":"1998"},{"key":"b26-jns091971","series-title":"Neurol Res","first-page":"478","article-title":"Recurrence of intracranial meningiomas: did better methods of diagnosis and surgical treatment change the outcome in the last 30 years?","volume":"31","author":"Strassner","year":"2009"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/5\/article-p1029.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/5\/article-p1029.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/5\/article-p1029.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T04:45:09Z","timestamp":1679892309000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/5\/article-p1029.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2010,11]]},"references-count":26,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2010.3.jns091971","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11]]}}}