Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression

More than 50% of atypical meningiomas regrow within 5 years after surgery. FORGE score is a newly created tool to estimate the MIB-1 index in cranial meningiomas. In this investigation, we aimed to assess the predictive value of the FORGE score in combination with major diagnostic criteria of atypic...

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Autores principales:	Johannes Wach, Tim Lampmann, Ági Güresir, Hartmut Vatter, Albert J. Becker, Michael Hölzel, Marieta Toma, Erdem Güresir
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	atypical meningioma FORGE prediction recurrence Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/0238ad1808ea412b8eb2241fe1a8ac91
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spelling	oai:doaj.org-article:0238ad1808ea412b8eb2241fe1a8ac912021-11-25T17:20:44ZCombining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression10.3390/diagnostics111120112075-4418https://doaj.org/article/0238ad1808ea412b8eb2241fe1a8ac912021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2011https://doaj.org/toc/2075-4418More than 50% of atypical meningiomas regrow within 5 years after surgery. FORGE score is a newly created tool to estimate the MIB-1 index in cranial meningiomas. In this investigation, we aimed to assess the predictive value of the FORGE score in combination with major diagnostic criteria of atypical meningioma (brain invasion, mitotic count ≥ 4) regarding recurrence in atypical meningiomas. We included patients operated on primary atypical meningiomas in our center from 2011 to 2019. The study included 71 patients (58% women, median age 63 years). ROC curves revealed a superiority of FORGE score combined with histopathological diagnostic criteria of atypical meningioma (AT-FORGE) in the prediction of tumor progression compared to FORGE score only (AUC: 0.72; 95% CI: 0.54–0.91, cut-off: ≥5/<5, sensitivity: 75%, specificity: 78%). Patients with an AT-FORGE score ≥ 5 had a shorter time to tumor progression (32.8 vs. 71.4 months, <i>p</i> < 0.001) in the univariable analysis. Multivariable cox regression analysis revealed significant predictive value of Simpson grade > II, presence of multiple meningiomas and AT-FORGE score ≥ 5 for tumor progression. The combination of histopathological diagnostic criteria for atypical meningioma with FORGE score might facilitate an effective identification of patients with an atypical meningioma who have an increased risk of tumor progression.Johannes WachTim LampmannÁgi GüresirHartmut VatterAlbert J. BeckerMichael HölzelMarieta TomaErdem GüresirMDPI AGarticleatypical meningiomaFORGEpredictionrecurrenceMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2011, p 2011 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atypical meningioma FORGE prediction recurrence Medicine (General) R5-920
spellingShingle	atypical meningioma FORGE prediction recurrence Medicine (General) R5-920 Johannes Wach Tim Lampmann Ági Güresir Hartmut Vatter Albert J. Becker Michael Hölzel Marieta Toma Erdem Güresir Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
description	More than 50% of atypical meningiomas regrow within 5 years after surgery. FORGE score is a newly created tool to estimate the MIB-1 index in cranial meningiomas. In this investigation, we aimed to assess the predictive value of the FORGE score in combination with major diagnostic criteria of atypical meningioma (brain invasion, mitotic count ≥ 4) regarding recurrence in atypical meningiomas. We included patients operated on primary atypical meningiomas in our center from 2011 to 2019. The study included 71 patients (58% women, median age 63 years). ROC curves revealed a superiority of FORGE score combined with histopathological diagnostic criteria of atypical meningioma (AT-FORGE) in the prediction of tumor progression compared to FORGE score only (AUC: 0.72; 95% CI: 0.54–0.91, cut-off: ≥5/<5, sensitivity: 75%, specificity: 78%). Patients with an AT-FORGE score ≥ 5 had a shorter time to tumor progression (32.8 vs. 71.4 months, <i>p</i> < 0.001) in the univariable analysis. Multivariable cox regression analysis revealed significant predictive value of Simpson grade > II, presence of multiple meningiomas and AT-FORGE score ≥ 5 for tumor progression. The combination of histopathological diagnostic criteria for atypical meningioma with FORGE score might facilitate an effective identification of patients with an atypical meningioma who have an increased risk of tumor progression.
format	article
author	Johannes Wach Tim Lampmann Ági Güresir Hartmut Vatter Albert J. Becker Michael Hölzel Marieta Toma Erdem Güresir
author_facet	Johannes Wach Tim Lampmann Ági Güresir Hartmut Vatter Albert J. Becker Michael Hölzel Marieta Toma Erdem Güresir
author_sort	Johannes Wach
title	Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
title_short	Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
title_full	Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
title_fullStr	Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
title_full_unstemmed	Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression
title_sort	combining forge score and histopathological diagnostic criteria of atypical meningioma enables risk stratification of tumor progression
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/0238ad1808ea412b8eb2241fe1a8ac91
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Combining FORGE Score and Histopathological Diagnostic Criteria of Atypical Meningioma Enables Risk Stratification of Tumor Progression

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