Prognostic value of MIB-1 index in meningioma: a retrospective cohort study to establish an optimal cutoff for recurrence and survival.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2025-05-12 DOI:10.1007/s11060-025-05057-2

Ishav Y Shukla, Ali Ebada, Nicholas Bever, Jeffrey I Traylor, Bingchun Wan, Darsh Shah, Samuel L Barnett, Matthew Z Sun

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引用次数: 0

Abstract

Purpose: Predicting long-term outcomes after meningioma resection remains challenging. Ki-67/MIB-1 correlates with recurrence, yet its optimal cutoff is undefined. This study aims to establish a threshold that enhances risk stratification, improves recurrence prediction, and informs postoperative surveillance and adjuvant treatment strategies.

Methods: This is retrospective study of patients who underwent meningioma resection. Receiver operating characteristic (ROC) analysis determined the optimal MIB-1 cutoff for predicting recurrence and survival, providing area under the curve (AUC). This cutoff was then applied in Kaplan-Meier survival analyses and multivariable Cox regressions, controlling for age, sex, tumor diameter, tumor location, extent of resection, and adjuvant radiotherapy.

Results: A total of 404 patients were included. Median age was 55.0 years (range: 16-85) and 72.3% were female. The cohort primarily consisted of WHO Grade 1 (69.6%) and Grade 2 (30.0%) meningiomas. An optimal MIB-1 index cutoff of 4.1% was identified using ROC analysis with the Youden index for predicting recurrence (AUC = 0.661, p < 0.001) and survival (AUC = 0.717, p < 0.001). 241 patients (59.7%) had a MIB-1 < 4.1%, and 163 (40.3%) had a MIB-1 ≥ 4.1%. Patients with MIB-1 ≥ 4.1% had a higher risk of recurrence (HR = 2.9, p = 0.009) and mortality (HR = 2.8, p = 0.036). Patients with MIB-1 ≥ 4.1% demonstrated shorter recurrence-free survival (RFS) (119.0 vs. 129.0 months, p < 0.001) and overall survival (OS) (163.0 vs. 229.0 months, p < 0.001).

Conclusion: We identified an optimal and actionable MIB-1 index cutoff of 4.1% which independently predicted recurrence, mortality, and shorter RFS and OS for patients undergoing meningioma resection. As the first study to establish and validate this threshold, our findings highlight its potential as an adjunct prognostic tool to refine risk stratification and guide postoperative management.

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脑膜瘤中mb -1指数的预后价值：一项回顾性队列研究，以建立复发和生存的最佳截止。

目的：预测脑膜瘤切除术后的长期预后仍然具有挑战性。Ki-67/MIB-1与复发相关，但其最佳截止值尚未确定。本研究旨在建立一个阈值，以加强风险分层，改善复发预测，并为术后监测和辅助治疗策略提供信息。方法：对脑膜瘤切除术患者进行回顾性研究。受试者工作特征（ROC）分析确定预测复发和生存的最佳MIB-1截止点，提供曲线下面积（AUC）。然后将该截止值应用于Kaplan-Meier生存分析和多变量Cox回归，控制年龄、性别、肿瘤直径、肿瘤位置、切除程度和辅助放疗。结果：共纳入404例患者。中位年龄55.0岁（范围16-85岁），72.3%为女性。该队列主要由WHO 1级（69.6%）和2级（30.0%）脑膜瘤组成。使用约登指数预测复发的ROC分析确定了4.1%的最佳mb -1指数截止值（AUC = 0.661, p）。结论：我们确定了4.1%的最佳和可操作的mb -1指数截止值，独立预测脑膜瘤切除术患者的复发、死亡率和较短的RFS和OS。作为第一个建立和验证这一阈值的研究，我们的研究结果强调了其作为辅助预后工具的潜力，以完善风险分层和指导术后管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.