Meningioma Recurrences: Risk Factors and Management
A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".
Deadline for manuscript submissions: 31 August 2025 | Viewed by 1037
Special Issue Editors
Interests: neurosurgery; neuro-oncology; neuropathology
Special Issues, Collections and Topics in MDPI journals
Interests: neuropathology; neuro-oncology
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
Intracranial meningiomas often recur even after gross total resection with or without adjuvant radiotherapy, with a rate ranging from 10 to 32 % at 10 years. The main risk factors include the WHO grade, the proliferation index ki-67, MIB 1, the extent of resection according to the Simpson classification and the postoperative adjuvant treatments. Other investigated factors are patient age and sex, tumor size and morphology, brain invasion.
The molecular biology of meningiomas has increasingly been studied in the last 15 years. Some molecular markers have been investigated, including NF-2, TRAF 7, SMO,POLR2A and TERT. They were found to be correlated with meningeal development and tumor location, tumor histological subtype, meningioma growth and aggressiveness.
The time of recurrence is rather variable. Although most recurrences occur within 5–7 years after the initial surgery, some meningiomas may recur even after more than 10 years. No gross total resection and high values of Ki-67 MIB-1 are predicting factors of shorter recurrences; these cases need a closer short-term clinical and radiological follow-up in the first few years after the operation.
Meningiomas may recur with different growth patterns. Most recur at the previous dural site or/and at its periphery, within 2 cm (local–peripheral); however, multi centric and diffuse recurrences may sometimes be observed. Flat-shaped tumor morphology with dural infiltration and high KI-67 and MIB 1 values at initial diagnosis are risk factors of diffuse regrowth.
The management of meningioma recurrences is often challenging. Gross total resection must be realized when possible, while preserving the neurological function. However, this is often hindered by several anatomical conditions, such as diffuse patterns of regrowth, loss of the brain tumor interface, extensive dural invasion and bone invasion in basal meningiomas.
Thus, the resection is often partial. Adjuvant radiotherapy is mandatory, if not already performed after the initial surgery.
Prof. Dr. Francesco Maiuri
Dr. Marialaura Del Basso De Caro
Guest Editors
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Keywords
- meningioma
- recurrences
- risk factors
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