Grade 3 Meningioma Survival and Recurrence Outcomes in an International Multicenter Cohort
Bibliographic record
Abstract
Objective: Grade 3 meningioma represents a rare meningioma subtype, for which limited natural history data are available. The objective of this study was to describe the demographic and pathologic characteristics, clinical and functional status outcomes, and identify prognostic factors in an international cohort of grade 3 meningioma patients. Methods: Clinical and histopathological data were collected for patients treated at seven sites across North America and Europe between 1991 and 2022. Results: 103 patients (54% female), median age 65 years (IQR: 52, 72) were included. Sixty-seven (65%) cases represented de novo grade 3 lesions, whereas 29 (28%) represented malignant transformations of lower grade meningiomas. All patients underwent initial operative resection of their tumor. Patients were followed for a median of 46 months (IQR: 24, 108), during which time there were 65 recurrences (63%) and 50 deaths (49%). The 5-year overall survival (OS) and progression-free survival (PFS) rates were 66% (95% CI: 56-767%) and 37% (95% CI: 28–48%), respectively. Age ≥65 years old and male sex were independent predictors of worse OS and PFS in multivariate regression analysis, while postoperative radiotherapy was independently associated with improved OS. Karnofsky Performance Status (KPS) remained stable relative to baseline over 5 years postdiagnosis among participants who were living at the end of the follow-up period. Conclusions: This large multi-center study provides insight into the longitudinal outcomes of grade 3 meningioma, with respect to recurrence, survival and functional status. Our study affirms the survival benefit conferred by radiotherapy in this population and suggests good functional status outcomes for patients surviving to 5 years postoperatively. Publication History Article published online: 05 February 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".