Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
Vol. 24, No. 3, 2017, pp. 33-43
Bioline Code: mj17033
Full paper language: English
Document type: Research Article
Document available free of charge
Malaysian Journal of Medical Sciences, Vol. 24, No. 3, 2017, pp. 33-43
© Copyright 2017 - Penerbit Universiti Sains Malaysia
Prediction of Histological Grade and Completeness of Resection of Intracranial Meningiomas: Role of Peritumoural Brain Edema|
Palaniandy, Kamalanathan; Mohammad Haspani, Mohammad Saffari & Mohd Zain, Norzaini Rose
Background: Meningioma is the commonest primary intracranial tumour in adults.
Excision is curative for low grade meningioma, whereas high-grade meningioma requires
adjuvant therapy following surgery. Several studies have examined the association between
peritumoural brain Edema — a common feature in meningioma — and histological grading with
mixed results. The present study attempted to elucidate this association and if peritumoural brain
Edema affects the intra-operative judgement of surgeons on the completeness of resection.
Methods: An observational study was conducted among those who underwent surgery
for meningioma. Eighteen subjects were recruited each for low- and high-grades, respectively.
Magnetic resonance imaging (MRI) prior to surgery was employed for interpreting the Edema
index and MRI after surgery was used to determine residual tumour.
Results: Median age was 50 years, male to female ratio was 1:3.5, 69.4% had peritumoural
brain Edema and 75% had reported gross resection. Among the reported gross total resection
cases, 40.7% had residual tumour. Analysis showed statistically significant association between
peritumoural brain Edema (P = 0.027) and tumour volume (P = 0.001) with high-grade
meningioma, however multivariate analysis did not present any association. No association was
noted between judgement of tumour resection by surgeons and peritumoural brain Edema.
Conclusion: Odds ratio for peritumoural brain Edema remained high and the
tumour volume exhibited marginal P-value marginal significance for prediction of high grade
meningioma. These two factors may still contribute to the tumour grade and should be included in
further studies on the prognosis of meningioma.
meningioma; Edema; resection
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