PURPOSE The aim of this study was to systematically analyze the clinical characteristics of a large cohort of parasagittal meningioma (PM) and to evaluate the patients' outcomes and best treatment strategies based on tumor features. METHODS To minimize selection bias we performed a single-institutional review of PM with restricted criteria. One hundred and ninety-two consecutive patients who met criteria for inclusion were reviewed from 2003 to 2011 in our general hospital. RESULTS A total of 131 cases (68.2%) were with WHO grade I, while grade II and grade III PMs constituted 40 (20.8%) and 21 cases (10.9%). Higher histological grade was associated with loss of trimethylation of H3K27 (P = 0.000). For WHO grade I PMs, GTR was significantly associated with a better PFS (P = 0.023); however, adjuvant radiotherapy did not benefit patients with STR (P = 0.215). For de novo high-grade (WHO grade II and III) PMs (n = 37), adjuvant radiotherapy was associated with a significantly longer OS (P = 0.013), while no difference was observed between GTR and STR (P = 0.654). In recurrent high-grade PM patients (n = 24), GTR combined with adjuvant radiotherapy increased PFS (P = 0.005). CONCLUSIONS This study demonstrated that PMs were a heterogeneous group of tumors with a high proportion of high-grade tumors that often displayed aggressive clinical behaviors. Low-grade PM benefited from radical resection, whereas high-grade de novo PM did not. Adjuvant radiotherapy significantly prolonged OS for high-grade primary PM, but did not impact survival of patients with subtotally resected low-grade tumors. Long-term outcome of high-grade recurrent PMs was dismal. We thus show that extent of tumor resection, tumor grade and tumor recurrent status inform therapeutic decisions for PMs.

中文翻译：

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矢状旁脑膜瘤多模式管理的长期结果。

目的本研究的目的是系统分析一大批矢状旁矢状脑膜瘤（PM）的临床特征，并根据肿瘤特征评估患者的预后和最佳治疗策略。方法为了尽量减少选择偏见，我们对单项PM进行了单机构审查，并采用了受限标准。2003年至2011年，在我们的综合医院对符合入选标准的112例患者进行了回顾。结果共有131例（68.2％）属于WHO WHO一级，而II级和III级PM分别占40例（20.8％）和21例（10.9％）。较高的组织学等级与H3K27的三甲基化损失有关（P = 0.000）。对于世界卫生组织的I级PM，GTR与更好的PFS显着相关（P = 0.023）；然而，辅助放疗并未使STR患者受益（P = 0.215）。对于从头开始（WHO II级和III级）PM（n = 37），辅助放疗与更长的OS相关（P = 0.013），而GTR和STR之间无差异（P = 0.654）。在复发的高级别PM患者（n = 24）中，GTR联合辅助放疗可增加PFS（P = 0.005）。结论这项研究表明PM是异质性肿瘤群，其中高比例的高级别肿瘤通常表现出侵略性的临床行为。低度PM受益于根治性切除术，而高水平的de novo PM则没有。辅助放疗可显着延长高级别原发性PM的OS，但不影响次全切除低级别肿瘤患者的生存。高级别复发性PM的长期结果令人沮丧。因此，我们表明肿瘤切除的程度，肿瘤的分级和肿瘤的复发状态为PM的治疗决策提供了依据。