Risk Factors For High Grade Meningioma

Objective:This study was designed to determine the independent risk factors of high-grade meningioma based on clinical data and imaging findings of meningioma patients,and to predict the pathological grade of meningioma without surgery to guide clinical treatment.Method: 720 patients with meningioma diagnosed by postoperative pathology were received surgically treatment between January 2013 and August 2018 in the Department of Neurosurgery of the Fujian Medical University Union Hospital.Chi-square test was applied to analyze the differences of each group of variables,and then statistically significant variables were included in univariate analysis and multivariate logistic regression analysis to determine whether each variable was an independent risk factor affecting the pathological grade of meningiomas.Result: Of the 720 patients identified,562(78.1%)had a WHO grade I tumor and in 158(21.9%)the tumors were WHO grade II/III.The median largest tumor dimension was3.82 cm(range 0.8–10 cm).Variance analysis showed that gender,age,tumor location,tumor diameter,history of meningioma resection in the pathologic stage statistically significant(P < 0.05).On univariate regression,male sex(P < 0.001),age ≥65years(P=0.031),non-skull base location(P = 0.013),larger tumor size(P < 0.001)and history of meningioma resection(P < 0.001)were significant risk of WHO grade II/III pathology.After controlling for interactions,multivariate regression found male sex(OR3.71,95% CI 2.42–5.69),history of meningioma resection(OR 4.56,95% CI 2.37–8.77),non-skull base location(OR 2.02 95% CI 1.33-3.07),and size 3–6 cm(OR 2.71,95% CI1.62–4.54),size > 6 cm(OR 4.25,95% CI 2.11–8.54))to be significantly associated with WHO grade II/III.Conclusion: Males,non-skull base location,history of meningioma resection,and larger tumor size will increase the risk of high grades meningioma.These risk factors should be carefully considered when advising patients on treatment and prognosis.