Proliferative Potential, and Inflammatory Tumor Microenvironment in Meningioma Correlate with Neurological Function at Presentation and Anatomical Location-From Convexity to Skull Base and Spine.
Johannes WachTim LampmannÁgi GüresirHartmut VatterUlrich HerrlingerAlbert BeckerSilvia Cases-CunilleraMichael HölzelMarieta TomaErdem GüresirPublished in: Cancers (2022)
Emerging evidence emphasizes the prognostic importance of meningioma location. The present investigation evaluates whether progression-free survival (PFS), proliferative potential, World Health Organization (WHO) grades, and inflammatory burden differ between anatomical locations (skull base, non-skull base, and spinal) meningiomas. Five-hundred-forty-one patients underwent Simpson grade I or II resection for WHO grade 1 or 2 meningiomas. Univariable analysis revealed that spinal meningioma patients are significantly older, had a worse baseline Karnofsky Performance Status (KPS), higher acute-phase protein levels, lower incidence of WHO grade 2, lower mitotic counts, lower MIB-1 index, and less CD68 + macrophage infiltrates. Multivariable analysis identified WHO grade 2 (OR: 2.1, 95% CI: 1.1-3.7, p = 0.02) and cranial location (OR: 3.0, 95% CI: 1.8-4.9, p = 0.001) as independent predictors of diffuse CD68 + macrophage infiltrates. The mean PFS in cranial meningiomas was 115.9 months (95% CI: 107.5-124.3), compared to 162.2 months (95% CI: 150.5-174.0; log-rank test: p = 0.02) in spinal meningiomas. Multivariable Cox regression analysis revealed cranial location as an independent predictor (HR: 4.7, 95% CI: 1.0-21.3, p = 0.04) of shortened PFS. Increased MIB-1 indices ≥5% were significantly associated with location-specific deficits at presentation, such as decreased vision and seizure burden. Spinal meningiomas have a significantly longer PFS time and differ from the cranial meningiomas regarding MIB-1 index and density of tumor-associated macrophages.
Keyphrases
- end stage renal disease
- spinal cord
- chronic kidney disease
- ejection fraction
- newly diagnosed
- free survival
- adipose tissue
- peritoneal dialysis
- prognostic factors
- risk factors
- physical activity
- single cell
- spinal cord injury
- cell proliferation
- patient reported
- blood brain barrier
- community dwelling
- nk cells
- cerebral ischemia