Molecular Pathological Risk Grade Evaluates Biological Behavior and Prognosis of Patients with WHO Grade 1 Meningiomas

Abstract

ObjectiveTo explore the correlation of molecular pathological grading with WHO grade 1 meningioma recurrence, malignant progression, and patients’ survival. MethodsThe medical records and paraffin-embedded tissues of patients with surgically resected WHO grade 1 meningioma were collected. The molecular pathological risk grading suggested by Maas et al. was adopted, and the patients were graded as low, intermediate, and high risk. Univariate log-rank test and multivariate Cox regression analyses were performed to determine the relationship between molecular risk grading and patient progression-free survival (PFS), malignant progression-free survival (MPFS), and overall survival (OS). ResultsAmong 198 patients, 152 (76.8%) were graded as low risk, showing no 1p deletion; 42 (21.2%) patients were graded as intermediate risk, including 18 patients with 1p deletion, 10 patients with 1p combined with 6q deletion, and 14 patients with 1p combined with 14q deletion; and 4 (2%) patients were graded as high risk, including two patients with TERT promoter mutation, one patient with CDKN2A/B homozygous deletion, and one patient with 1p, 6p, and 14q combined deletion. Multivariate analysis showed that molecular risk grading was negatively associated with PFS (HR: 0.029, 95%CI: 0.011-0.080), MPFS (HR: 0.032, 95%CI: 0.004-0.274), and OS (HR: 0.074, 95%CI: 0.032-0.174; P<0.05). ConclusionThe biological behavior of histological grade 1 meningiomas still exhibits heterogeneity, and further molecular pathological risk grading can more accurately reflect their biological behavior and evaluate patient prognosis.

Keywords

• meningioma
• molecular pathology
• prognosis