Retrospective analysis of recurrence patterns and clinical outcomes in grade I-III meningiomas after surgery.

Background: The objective of this study was to evaluate the outcomes of meningioma patients with the World Health Organization (WHO) grades I-III who underwent surgical resection and identify factors influencing recurrence and survival.

Methods: This retrospective study included patients who underwent surgery for meningioma at the National Brain Center Hospital between January 2020 and December 2022. Clinical characteristics of patients with recurrence, such as gender, age, preoperative Karnofsky Performance Scale (KPS), grading, and history of radiotherapy, were recorded. The recurrence time was assessed within 2 years post-surgery. Magnetic resonance imaging or computed tomography imaging results were used to determine meningioma location, while the WHO grading was based on pathological findings. Survival analysis of recurrence across different grades was performed using Kaplan-Meier curves.

Results: Of the 184 patients who had surgical resection for meningioma, 53 (28.8%) experienced recurrence. The recurrence group consisted primarily of women (81%), with a preoperative KPS > 70% (83%), Simpson grading II-III (60.3%), WHO grade II (39.6%), and meningiomas located in the convexity (24.5%). Most patients (81.1%) had no history of radiotherapy, and 64.15% had two or more resections. The average recurrence-free period after surgery was 17.95 ± 20.39 months. Mortality due to recurrence was most common in the WHO grade II patients (11.1%). Kaplan-Meier curves showed differences in recurrence between grading subgroups, with the WHO grade III meningiomas exhibiting the highest recurrence rate and the worst prognosis.

Conclusion: Higher-grade meningiomas are more likely to recur and result in poorer outcomes. Further research is needed to investigate tumor recurrence at the molecular level. A multidisciplinary approach to treatment improves outcomes and reduces complications associated with recurrence.