The use of adjuvant radiotherapy is controversial in patients with atypical meningiomas treated with gross total resection (GTR). This study aimed to determine whether clinico-pathological features could be helpful to predict the recurrence risk in this group of patients and to identify high-risk ones who could benefit from adjuvant treatment. We collected 200 patients with primary atypical meningiomas treated with GTR but with no adjuvant radiotherapy from 5 different centers. A risk score, formulated by assigning 1 point for the presence and 0 points for the absence of 5 high-risk parameters (male sex, parasagittal site, Simpson grade 3, mitotic index ≥ 6/10 HPF, and sheeting), was the most significant predictor of recurrence. A score ≥2 was associated with 4.7 risk of shorter disease-free survival (p < 0.0001). Our findings indicate that the presence of at least 2 clinico-pathological high-risk factors predicts recurrence of totally resected primary atypical meningiomas and could be helpful for identifying patients who could benefit from adjuvant radiotherapy.

中文翻译：

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基于 5 个临床病理变量的风险评分预测非典型脑膜瘤的复发

在接受大体全切除术 (GTR) 治疗的非典型脑膜瘤患者中，辅助放疗的使用存在争议。本研究旨在确定临床病理特征是否有助于预测这组患者的复发风险，并确定可以从辅助治疗中受益的高风险患者。我们从 5 个不同的中心收集了 200 名接受 GTR 治疗但未接受辅助放疗的原发性非典型脑膜瘤患者。风险评分，通过将 5 个高风险参数（男性、矢状旁部位、Simpson 3 级、有丝分裂指数 ≥ 6/10 HPF 和薄片）的存在分配 1 分和不存在分配 0 分来制定的风险评分是最复发的重要预测因子。评分≥2 与 4.7 的无病生存期风险缩短相关（p < 0.0001）。