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New Classification Scheme for the Prognostic Stratification of Meningioma on
the Basis of Chromosome 14 Abnormalities, Patient Age, and Tumor Histopathology
Angel Maíllo, Alberto Orfao, José
María Sayagués, Pedro Díaz, Juan Antonio Gómez-Moreta,
Marcelino Caballero, David Santamarta, Angel
Santos-Briz, Francisco Morales, María Dolores
Tabernero
From the Neurosurgery Service, Pathology Service, and Unidad
de Investigación, Hospital Universitario de Salamanca; and Centro de
Investigaciones del Cáncer, Cytometry General Service and Department of
Medicine, University of Salamanca; Salamanca, Spain. Address reprint requests to Angel Maíllo, MD, Servicio de
Neurocirugía, Hospital Universitario de Salamanca, Paseo de San Vicente 58,
37007 Salamanca, Spain; e-mail: a_maillo@yahoo.es.
Purpose. Meningiomas are usually considered benign tumors.
However, relapses occur in 10% to 20% of all patients, including both
histopathologically aggressive and benign tumors.
This study explored
the value of numerical abnormalities for 10 different chromosomes in
meningiomas for predicting relapse-free survival (RFS). Patients and
Methods. This study prospectively analyzed the
frequency of numerical abnormalities of chromosomes 1, 9, 10, 11,
14, 15, 17, 22, X, and Y in 70 meningioma patients by fluorescence in
situ hybridization and their relationship with disease characteristics at
diagnosis and patients’ outcome. Results.
Results showed the presence of numerical abnormalities
for one or more chromosomes in most patients (77%).
Chromosome 22
in the whole series and chromosome Y in males were those more
frequently altered, followed by chromosomes 1, 14, and X in females.
Patients with abnormalities of chromosomes 1, 9, 10, 11, 14, 15, 17,
the sex chromosomes, and gains of chromosome 22 were associated with
adverse prognostic features, more frequent relapses, and shorter RFS.
Multivariate analysis showed that tumor grade together with
chromosome 14 status and age were the best combination of independent
variables for predicting RFS.
According to these variables, all
patients with a score of two or more than two adverse prognostic
factors had experienced relapse at 5 years, whereas none of those
with a score of zero had experienced relapse 10 years after surgery. Conclusion.
In addition to age and histologic grade,
abnormalities of chromosome 14 contribute to a better prognostic
stratification of meningioma patients at diagnosis.
Additional
prospective studies in larger series of patients, also including
larger numbers of patients who experienced relapse, are necessary to
confirm the utility of the proposed predictive model.
Partially supported by grants from the Fondo de Investigaciones Sanitarias
(FIS 01/1564 and PI 020010, Madrid, Spain), the Consejeria de Sanidad
of the Junta de Castilla-Leon (Acción Biomedicina, Exp 02/02,
Valladolid, Spain), and the Fundación memoria de D. Samuel Solorzano
Barruso (Salamanca, Spain). M.D.T. is supported by a grant from the
programa Ramón y Cajal (Ministerio de Ciencia y Tecnología, Madrid,
Spain), and J.M.S. is supported by a grant (02/9103) from Ministerio
de Sanidad y Consumo (Madrid, Spain).
© 2003 American Society for Clinical Oncology
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