{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:54Z","timestamp":1789538694743,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intracranial anaplastic meningioma, currently classified as World Health Organization (WHO) Grade III, is a rare and biologically aggressive tumor with a high recurrence rate. Due to its rarity, the available literature on its clinical characteristics and prognostic factors remains limited. In this study, we aimed to evaluate the relative impact of the extent of surgical resection and adjuvant radiotherapy on long-term survival and recurrence control in patients with intracranial anaplastic meningioma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients with histopathologically confirmed World Health Organization (WHO) Grade III meningioma. Among 5,962 cases treated between January 2012 and July 2022, 46 patients with complete follow-up data were included. Clinical characteristics, treatment modalities, and outcomes were analyzed. Kaplan\u2013Meier analysis was used to assess progression-free survival (PFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During follow-up, 38 patients (82.6%) experienced tumor recurrence. The median PFS was 24 months, with 2- and 5-year recurrence rates of 52.0% and 77.0%, respectively. The median OS was 68 months, with 2- and 5-year OS rates of 79.7% and 56.5%. Simpson Grade I\/II resection was associated with longer OS than Grade III\/IV resection, although the difference was not statistically significant. Adjuvant radiotherapy showed a trend toward improved OS but did not reach statistical significance. In contrast, radiotherapy was associated with delayed recurrence and prolonged PFS, particularly in terms of early recurrence control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intracranial anaplastic meningioma is characterized by high recurrence and poor prognosis. In this cohort, neither extent of resection nor adjuvant radiotherapy reached a statistically significant improvement in overall survival, whereas both were associated with delayed tumor recurrence. These findings suggest that current treatment strategies may primarily provide temporal disease control rather than substantially altering long-term survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1841444","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:32:33Z","timestamp":1789536753000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extent of resection and adjuvant radiotherapy in intracranial anaplastic meningioma: improved disease control with no statistically significant overall survival benefit"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanming","family":"Miao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital","place":["Beijing, China"]},{"name":"Capital Medical University Electric Power Teaching Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibin","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital","place":["Beijing, China"]},{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Capital Medical University Electric Power Teaching Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifeng","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangning","family":"Shui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Zong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dabiao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/s13014-024-02486-7","article-title":"Re-irradiation of anaplastic meningioma: higher dose and concomitant bevacizumab may improve progression-free survival","volume":"19","author":"Haisraely","year":"2024","journal-title":"Radiat Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1007\/s00234-022-03008-6","article-title":"2021 WHO classification of tumours of the central nervous system: a review for the neuroradiologist","volume":"64","author":"McNamara","year":"2022","journal-title":"Neuroradiology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"101562","DOI":"10.1016\/j.canep.2019.07.001","article-title":"Incidence, mortality and outcome of meningiomas: a population-based study from Germany","volume":"62","author":"Holleczek","year":"2019","journal-title":"Cancer Epidemiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.3390\/cancers14071706","article-title":"Gemcitabine cooperates with everolimus to inhibit the growth of and sensitize malignant meningioma cells to apoptosis induced by navitoclax, an inhibitor of anti-apoptotic BCL-2 family proteins","volume":"14","author":"Yamamoto","year":"2022","journal-title":"Cancers"},{"key":"B5","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3171\/2016.11.JNS161170","article-title":"Intermediate-risk meningioma: initial outcomes from NRG oncology RTOG 0539","volume":"129","author":"Rogers","year":"2018","journal-title":"J Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","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","volume":"122","author":"Zhi","year":"2019","journal-title":"World Neurosurg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1093\/nop\/npae117","article-title":"An evidence-based framework for postoperative surveillance of meningioma","volume":"12","author":"Owusu-Adjei","year":"2024","journal-title":"Neurooncol Pract"},{"key":"B8","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.nec.2023.02.013","article-title":"The role of radiotherapy in the treatment of higher-grade meningioma","volume":"34","author":"Lee","year":"2023","journal-title":"Neurosurg Clin N Am"},{"key":"B9","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.jocn.2021.06.047","article-title":"Neurosurgical follow-up and treatment of a series of 26 WHO grade III meningiomas","volume":"91","author":"G\u00fcd\u00fck","year":"2021","journal-title":"J Clin Neurosci"},{"key":"B10","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s11060-022-04220-3","article-title":"DNA methylation profiling of meningiomas highlights clinically distinct molecular subgroups","volume":"161","author":"Singh","year":"2023","journal-title":"J Neurooncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s11060-025-05165-z","article-title":"Repeated stereotactic radiosurgery for high grade meningioma","volume":"175","author":"Peng","year":"2025","journal-title":"J Neurooncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s11060-020-03674-7","article-title":"Meta-analysis of adjuvant radiotherapy for intracranial atypical and malignant meningiomas","volume":"152","author":"Unterberger","year":"2021","journal-title":"J Neurooncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"244","DOI":"10.14791\/btrt.2022.0030","article-title":"Anaplastic meningioma: clinical characteristics, prognostic factors and survival outcome","volume":"10","author":"Seo","year":"2022","journal-title":"Brain Tumor Res Treat"},{"key":"B14","doi-asserted-by":"publisher","first-page":"9631","DOI":"10.3390\/ijms25179631","article-title":"The molecular and immunological landscape of meningiomas","volume":"25","author":"Lotsch","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s00701-024-06336-z","article-title":"Prognostic role of extent of resection and adjuvant radiotherapy in de novo anaplastic meningiomas","volume":"166","author":"Marijon","year":"2024","journal-title":"Acta Neurochir"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e758","DOI":"10.1016\/j.wneu.2022.07.099","article-title":"Survival benefit of prognostic factors and treatment in adult patients with recurrent anaplastic meningioma: a retrospective case series and systematic literature review","volume":"166","author":"Zhang","year":"2022","journal-title":"World Neurosurg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.nec.2023.02.011","article-title":"Management of atypical and anaplastic meningiomas","volume":"34","author":"Higgins","year":"2023","journal-title":"Neurosurg Clin N Am"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1189606","DOI":"10.3389\/fnins.2023.1189606","article-title":"Meningiomas with CNS invasion","volume":"17","author":"Gousias","year":"2023","journal-title":"Front Neurosci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s10143-023-01969-7","article-title":"Efficacy of radiotherapy and stereotactic radiosurgery as adjuvant or salvage treatment in atypical and anaplastic (WHO grade II and III) meningiomas: a systematic review and meta-analysis","volume":"46","author":"Gagliardi","year":"2023","journal-title":"Neurosurg Rev"},{"key":"B20","doi-asserted-by":"publisher","first-page":"i67","DOI":"10.1093\/noajnl\/vdac088","article-title":"Radiotherapy and radiosurgery for meningiomas","volume":"5","author":"Chen","year":"2023","journal-title":"Neurooncol Adv"},{"key":"B21","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1007\/s00701-024-06157-0","article-title":"Atypical and anaplastic meningiomas in the later decades of life: a national cancer database analysis","volume":"166","author":"Karabacak","year":"2024","journal-title":"Acta Neurochir"},{"key":"B22","doi-asserted-by":"publisher","first-page":"802","DOI":"10.3390\/jpm14080802","article-title":"Radiosurgery in grade II and III meningiomas: a systematic review and meta-analysis","volume":"14","author":"Jahanbakhshi","year":"2024","journal-title":"J Pers Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s13014-018-1026-x","article-title":"Evaluation of particle radiotherapy for the re-irradiation of recurrent intracranial meningioma","volume":"13","author":"El Shafie","year":"2018","journal-title":"Radiat Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1093\/neuros\/nyaa553","article-title":"Stereotactic radiosurgery for atypical (world health organization II) and anaplastic (world health organization III) meningiomas: results from a multicenter, international cohort study","volume":"88","author":"Shepard","year":"2021","journal-title":"Neurosurgery"},{"key":"B25","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s11060-023-04537-7","article-title":"Ki-67 labeling index predicts tumor progression patterns and survival in patients with atypical meningiomas following stereotactic radiosurgery","volume":"167","author":"Umekawa","year":"2024","journal-title":"J Neurooncol"},{"key":"B26","doi-asserted-by":"publisher","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":"Louis","year":"2016","journal-title":"Acta Neuropathol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/neuonc\/nou148","article-title":"Phase II trial of sunitinib for recurrent and progressive atypical and anaplastic meningioma","volume":"17","author":"Kaley","year":"2015","journal-title":"Neuro Oncol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1007\/s11060-024-04625-2","article-title":"Inhibition of BMP signaling pathway induced senescence and calcification in anaplastic meningioma","volume":"167","author":"Yokogami","year":"2024","journal-title":"J Neurooncol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e633","DOI":"10.1016\/j.ijrobp.2012.01.079","article-title":"Fractionated proton radiotherapy for benign cavernous sinus meningiomas","volume":"83","author":"Slater","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1841444\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:32:34Z","timestamp":1789536754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1841444\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":29,"alternative-id":["10.3389\/fsurg.2026.1841444"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1841444","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]},"article-number":"1841444"}}