The relevance of the Simpson grading system as a predictor of meningioma progression or recurrence in modern neurosurgical practice has recently been called into question. The aim of our study was to compare the risk of progression/recurrence of tumours that had been treated with different Simpson grade resections in a contemporary population of benign (WHO grade I) meningioma patients. One hundred eighty-three patients with histologically confirmed WHO grade I meningioma were retrospectively analysed. All patients underwent first-time craniotomy as their initial therapy between 2004 and 2012. Univariate analysis was performed using log-rank testing and Kaplan-Meier analysis for progression/recurrence-free survival. Multivariate analysis was performed using Cox proportional hazards regression modelling. The three-year progression/recurrence-free survival rates for patients receiving Simpson grade 1, 2 or 4 resections were 95 %, 87 % and 67 %, respectively. Simpson grade 4 resections progressed/recurred at a significantly greater rate than Simpson grade 1 resections (hazard ratio [HR] = 3.26, P = 0.04), whereas Simpson grade 2 resections did not progress/recur at a significantly greater rate than Simpson grade 1 resections (HR = 1.78, P = 0.29). Subtotal resections progressed/recurred at a significantly greater rate than gross-total resections (HR = 2.47, P = 0.03). Tumours that undergo subtotal resection are at a significantly greater risk of progression/recurrence than tumours that undergo gross-total resection. Gross-total resection should therefore be the aim of surgery. However, given modern access to follow-up imaging and stereotactic radiosurgery, these results should not be used to justify overly 'heroic' tumour resection.
The relevance of the Simpson grading system as a predictor of meningioma progression or recurrence in modern neurosurgical practice has recently been called into question . The aim of our study was to compare the risk of progression / recurrence of tumours that had been treated with different Simpson grade resections in a contemporary population of benign ( WHO grade I ) meningioma patients . One hundred eighty - three patients with histologically confirmed WHO grade I meningioma were retrospectively analysed . All patients underwent first - time craniotomy as their initial therapy between 2004 and 2012 . Univariate analysis was performed using log - rank testing and Kaplan - Meier analysis for progression / recurrence - free survival . Multivariate analysis was performed using Cox proportional hazards regression modelling . The three - year progression / recurrence - free survival rates for patients receiving Simpson grade 1 , 2 or 4 resections were 95 % , 87 % and 67 % , respectively . Simpson grade 4 resections progressed / recurred at a significantly greater rate than Simpson grade 1 resections ( hazard ratio [ HR ] = 3.26 , P = 0.04 ) , whereas Simpson grade 2 resections did not progress / recur at a significantly greater rate than Simpson grade 1 resections ( HR = 1.78 , P = 0.29 ) . Subtotal resections progressed / recurred at a significantly greater rate than gross - total resections ( HR = 2.47 , P = 0.03 ) . Tumours that undergo subtotal resection are at a significantly greater risk of progression / recurrence than tumours that undergo gross - total resection . Gross - total resection should therefore be the aim of surgery . However , given modern access to follow - up imaging and stereotactic radiosurgery , these results should not be used to justify overly ' heroic ' tumour resection .
Simpson grading is used to describe resection of which brain tumor?
Simpson grading is used to describe resection of which brain tumor ?
meningioma
meningioma