Integration of MIB-1 Labeling Indices and Simpson Grades to Predict Meningioma Recurrence in Modern Neurosurgery

Soichi Oya, MD1, Hirofumi Nakatomi, MD, PhD1, Kensuke Kawai, MD, PhD1, Nobuhito Saito, MD, PhD1

1Saitma, Japan

Keywords: meningioma, molecular biology, grading system, recurrent disease, malignant meningioma

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     This study aims to assess the clinical significance and limitations of the Simpson grading system in relation to modern surgery for World Health Organization grade 1 benign meningiomas, and to explore the potential of the cell proliferation index to improve the prediction of tumor recurrence.
      total of 240 patients harboring 248 benign meningiomas were enrolled in this study.
     The surgical records of patients who underwent surgical resection of intracranial meningiomas at the University of Tokyo Hospital between January 1995 and August 2010 were retrospectively analyzed. We investigated the relationships between recurrence-free survival (RFS) and Simpson grade or MIB-1 labeling index value.
     ASimpson Grade IV resection was associated with a significantly shorter RFS than that associated with Simpson Grade I, Grade II, and Grade III resection (p < 0.001). However, RFS was not significantly different between patients who underwent Simpson Grade I, Grade II, or Grade III resection. Among these patients, however, a multivariate analysis on age, sex, tumor location, Simpson Grade, and MIB-1 labeling index revealed that only a MIB-1 index of 3% or higher was associated with a significantly shorter time to recurrence.
     This is a retrospective study.
     The clinical significance of the different management strategies related to Simpson Grade I, Grade II, and Grade III resection may have been diluted in the modern surgical era.
     The MIB-1 index can differentiate tumors with a high risk of recurrence, which could be beneficial for planning tailored optimal follow-up strategies.


Project Roles:

S. Oya (), H. Nakatomi (), K. Kawai (), N. Saito ()