• Neurosurgery · Sep 2023

    Multicenter Study

    Novel Postoperative Serum Biomarkers in Atypical Meningiomas: A Multicenter Study.

    • Won Ick Chang, Hwa Kyung Byun, Joo Ho Lee, Chul-Kee Park, In Ah Kim, Chae-Yong Kim, Jong Hee Chang, Seok-Gu Kang, Sang Hyung Lee, Yuki Kuranari, Ryota Tamura, Masahiro Toda, Chan Woo Wee, and Hong In Yoon.
    • Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
    • Neurosurgery. 2023 Sep 1; 93 (3): 599610599-610.

    BackgroundThere has been no known serum biomarker to predict the prognosis of atypical meningioma.ObjectiveTo investigate the prognostic impact of serum biomarkers in patients newly diagnosed with resected intracranial atypical meningiomas.MethodsThis study enrolled 523 patients with atypical meningioma who underwent surgical resection between 1998 and 2018 from 5 Asian institutions. Serum laboratory data within 1 week after surgery were obtained for analysis. Optimal cutoffs were calculated for each serum marker using the maxstat package of R.ResultsOf 523 patients, 19.5% underwent subtotal resection and 29.8% were treated with adjuvant radiation therapy (ART). Among the 523 patients, 454 were included in the multivariate analysis for the progression/recurrence (P/R) rate excluding patients with incomplete histopathologic or laboratory data. On multivariate analysis, tumor size >5 cm, subtotal resection, and postoperative aspartate aminotransferase/alanine transaminase (De Ritis) ratio >2 were associated with higher P/R rates, whereas ART and postoperative platelet count >137 × 10 3 /μL were associated with lower P/R rates. In the subgroup of patients treated with ART, tumor size >5 cm and postoperative neutrophil-to-lymphocyte ratio >21 were associated with higher P/R rates. By contrast, postoperative De Ritis ratio >2 remained an adverse prognosticator in patients not treated with ART.ConclusionPostoperative De Ritis ratio, platelet count, and neutrophil-to-lymphocyte ratio were revealed as a novel serum prognosticator in newly diagnosed atypical meningiomas. Additional studies are warranted to validate its clinical significance and biological background.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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