{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:34:47Z","timestamp":1791232487047,"version":"4.1.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,9]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The goal of this study was to determine whether the quantity of peritumoral brain edema displayed on computerized tomography (CT) scanning could be correlated with brain invasion and subsequent recurrence of meningiomas.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> One hundred thirty-five patients who underwent resection of intracranial meningiomas at the Ottawa Civic Hospital were followed during the period 1980 to 1998. A complete resection was defined as one in which tumor, invaded bone, and involved dura were removed. Tumors were examined microscopically for evidence of brain invasion. The mean follow-up period was 9 \u00b1 4 years (standard deviation [SD]) and the mean time to recurrence was 5 \u00b1 4 years (SD). The authors used a simple grading system based on the average thickness (in centimeters) of edema seen on an axial CT slice showing the most tumor.<\/jats:p><jats:p content-type=\"fine-print\">Edema grade was linearly related to edema volume determined by digitizing the scans (r = 0.96; 29 cases). The chance of brain invasion increased by 20% for each centimeter of edema (r<jats:sub>s<\/jats:sub> = 1, p &lt; 0.0001; 124 cases). The presence of brain invasion was predictive of recurrence after complete resection with an accuracy of 83%, a sensitivity of 89%, and a specificity of 82%. The chance of recurrence within 10 years after complete resection was given by the equation: percentage chance of recurrence = (centimeter of edema)<jats:sup>3<\/jats:sup> \u00d7 0.7, which can be used to predict the chance of recurrence based on findings on CT scans (r<jats:sub>s<\/jats:sub> = 1, p &lt; 0.0001; 86 patients). Statistical significance was confirmed using Kaplan\u2014Meier and univariate and multivariate analyses. Completeness of resection was the most powerful predictor of recurrence (p &lt; 0.00001, r = 0.6), followed by edema grade and brain invasion (both p = 0.02, r = 0.1). Patient age and gender and tumor location, size, and histological subtype were nonsignificant factors.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Brain invasion causes peritumoral edema. Invaded brain tissue is also the source of residual cells in cases of tumor recurrence after gross-total resection.<\/jats:p>","DOI":"10.3171\/jns.1999.91.3.0375","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:21:15Z","timestamp":1242235275000},"page":"375-383","source":"Crossref","is-referenced-by-count":104,"title":["Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning"],"prefix":"10.3171","volume":"91","author":[{"given":"Ross E.","family":"Mantle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boleslaw","family":"Lach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio R.","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salleh","family":"Baeesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"B\u00e9langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/0090-3019(94)90075-2","article-title":"Cerebral edema in intracranial meningiomas: evidence for local and diffuse patterns and factors associated with its occurrence.","volume":"42","author":"Abe","year":"1994"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3171\/jns.1983.58.1.0051","article-title":"The recurrence of intracranial meningiomas after surgical treatment.","volume":"58","author":"Adegbite","year":"1983"},{"key":"b3","series-title":"Neurosurgery","first-page":"730","article-title":"Tumor-related venous obstruction and development of peritumoral brain edema in meningiomas.","volume":"42","author":"Bitzer","year":"1998"},{"key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"368","DOI":"10.3171\/jns.1997.87.3.0368","article-title":"The importance of pial blood supply to the development of peritumoral brain edema in meningiomas.","volume":"87","author":"Bitzer","year":"1997"},{"key":"b5","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1007\/BF01410973","article-title":"Peritumoural brain oedema in intracranial meningiomas: influence of tumour size, location and histology.","volume":"139","author":"Bitzer","year":"1997"},{"key":"b6","series-title":"J Neurosurg Sci","first-page":"11","article-title":"Recurring intracranial meningiomas. Evaluation of some factors predisposing for tumor recurrence.","volume":"29","author":"Boker","year":"1985"},{"key":"b7","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3171\/jns.1986.64.1.0058","article-title":"Recurrence of intracranial meningiomas: the role played by regional multicentricity.","volume":"64","author":"Borovich","year":"1986"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"168","DOI":"10.3171\/jns.1986.65.2.0168","article-title":"Recurrence of intracranial meningiomas: the role played by regional multicentricity. Part 2. Clinical and radiological aspects.","volume":"65","author":"Borovich","year":"1986"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"52","DOI":"10.3171\/jns.1984.60.1.0052","article-title":"Morbidity, mortality, and quality of life following surgery for intracranial meningiomas. A retrospective study in 257 cases.","volume":"60","author":"Chan","year":"1984"},{"key":"b10","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1097\/00006123-199308000-00004","article-title":"Tumor prostaglandin levels correlate with edema around supratentorial meningiomas.","volume":"33","author":"Constantini","year":"1993"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1227\/00006123-198812000-00006","article-title":"Relationship between flow cytometric features and clinical behavior of meningiomas.","volume":"23","author":"Crone","year":"1988"},{"key":"b12","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1007\/BF01401825","article-title":"Cerebral oedema associated with WHO-I, WHO-II, and WHO-III-meningiomas: correlation of clinical, computed tomographic, operative and histological findings.","volume":"125","author":"de Vries","year":"1993"},{"key":"b13","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1227\/00006123-198306000-00001","article-title":"Cerebral edema associated with meningiomas.","volume":"12","author":"Gilbert","year":"1983"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1097\/00006123-199706000-00029","article-title":"Brain edema in meningiomas is associated with increased vascular endothelial growth factor expression.","volume":"40","author":"Goldman","year":"1997"},{"key":"b15","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"304","DOI":"10.3171\/jns.1998.88.2.0304","article-title":"Platelet-activating factor and edema surrounding meningiomas.","volume":"88","author":"Hirashima","year":"1998"},{"key":"b16","series-title":"Adv Neurol","first-page":"323","article-title":"Experimental peritumoral edema of the cat brain.","volume":"28","author":"Hossman","year":"1980"},{"key":"b17","series-title":"Neurol Med Chir","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2176\/nmc.32.65","article-title":"Peritumoral brain edema associated with meningioma\u2014histological study of the tumor margin and surrounding brain.","volume":"32","author":"Ide","year":"1992"},{"key":"b18","series-title":"Neurol Med Chir","doi-asserted-by":"publisher","first-page":"289","DOI":"10.2176\/nmc.35.289","article-title":"Growth rate of intracranial meningioma: tumor doubling time and proliferating cell nuclear antigen staining index.","volume":"35","author":"Ide","year":"1995"},{"key":"b19","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1002\/(SICI)1097-0142(19960701)78:1<133::AID-CNCR19>3.0.CO;2-0","article-title":"MIB-1 staining index and peritumoral brain edema of meningiomas.","volume":"78","author":"Ide","year":"1996"},{"key":"b20","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1227\/00006123-199208000-00002","article-title":"Peritumoral brain edema in meningiomas\u2014influence of vascular supply on its development.","volume":"31","author":"Inamura","year":"1992"},{"key":"b21","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/0090-3019(86)90259-4","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"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.3171\/jns.1996.85.6.1095","article-title":"Correlation of vascular endothelial growth factor messenger RNA expression with peritumoral vasogenic cerebral edema in meningiomas.","volume":"85","author":"Kalkanis","year":"1996"},{"key":"b23","series-title":"Neurosurgery","first-page":"394","article-title":"Grade zero removal of supratentorial convexity meningiomas.","volume":"33","author":"Kinjo","year":"1993"},{"key":"b24","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/BF01411166","article-title":"Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema.","volume":"138","author":"Lobato","year":"1996"},{"key":"b25","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/0090-3019(87)90109-1","article-title":"Cerebral edema associated with meningiomas.","volume":"27","author":"Maiuri","year":"1987"},{"key":"b26","series-title":"J Neurosurg Sci","first-page":"29","article-title":"Correlation between sex hormone receptors and peritumoral edema in intracranial meningiomas.","volume":"38","author":"Maiuri","year":"1994"},{"key":"b27","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"455","DOI":"10.3171\/jns.1999.90.3.0455","article-title":"Preoperative identification of meningiomas that are highly likely to recur.","volume":"90","author":"Nakasu","year":"1999"},{"key":"b28","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/0303-8467(92)90176-4","article-title":"Peritumoral cerebral edema in meningiomas: the role of the tumor-brain interface.","volume":"94","author":"Ohno","year":"1992"},{"key":"b29","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"793","DOI":"10.3171\/jns.1997.86.5.0793","article-title":"Long-term prognosis for atypical and malignant meningiomas: a study of 71 surgical cases.","volume":"86","author":"Palma","year":"1997"},{"key":"b30","series-title":"Neurosurgery","first-page":"295","article-title":"Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon.","volume":"14","author":"Philippon","year":"1984"},{"key":"b31","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1097\/00006123-199705000-00027","article-title":"Meningiomas: role of vascular endothelial growth factor\/vascular permeability factor in angiogenesis and peritumoral edema.","volume":"40","author":"Provias","year":"1997"},{"key":"b32","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3171\/jns.1987.66.5.0729","article-title":"Correlation of tumor plasminogen activator with peritumoral cerebral edema. A CT and biochemical study.","volume":"66","author":"Quindlen","year":"1987"},{"key":"b33","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1136\/jnnp.20.1.22","article-title":"The recurrence of intracranial meningiomas after surgical treatment.","volume":"20","author":"Simpson","year":"1957"},{"key":"b34","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1227\/00006123-198104000-00004","article-title":"Biological features of meningiomas that determine the production of cerebra edema.","volume":"8","author":"Smith","year":"1981"},{"key":"b35","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"797","DOI":"10.3171\/jns.1981.54.6.0797","article-title":"Microgravimetric analysis of human brain tissue. Correlation with computerized tomography scanning.","volume":"54","author":"Takagi","year":"1981"},{"key":"b36","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1023\/A:1005874926358","article-title":"Cerebral edema associated with meningiomas: the role of peritumoral brain tissue.","volume":"36","author":"Vaz","year":"1998"},{"key":"b37","series-title":"J Cell Sci","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1242\/jcs.107.5.1347","article-title":"Modulation of tight junction structure in blood-brain barrier endothelial cells. Effects of tissue culture, second messengers and cocultured astrocytes.","volume":"107","author":"Wolburg","year":"1994"},{"key":"b38","series-title":"Clin Exp Pharmacol Physiol","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1111\/j.1440-1681.1997.tb02117.x","article-title":"Astrocyte-conditioned medium induces blood-brain barrier properties in endothelial cells.","volume":"24","author":"Yamagata","year":"1997"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/91\/3\/article-p375.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/91\/3\/article-p375.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/91\/3\/article-p375.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:52:27Z","timestamp":1679881947000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/91\/3\/article-p375.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,9]]},"references-count":38,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1999.91.3.0375","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1999,9]]}}}