Survival and failure patterns in WHO grade I-III meningiomas: a single-center experience of surgery and radiotherapy
Bibliographic record
Abstract
IntroductionIntracranial meningiomas are the second most common tumor of the central nervous system, and they account for approximately 15-20% of all primary brain tumors in adults. There is persistent debate regarding optimal patient selection for possible treatment modalities, their timing and delivery, without any consistent management approach to treatment across institutions. The present study reports the institutional experience with WHO grades I to III meningioma patients treated at Montreal Jewish General Hospital.Materials and methodsA retrospective analysis of 137 patients with diagnosis of meningioma that were treated at the Montreal Jewish General Hospital (JGH) from 2008 to 2018 was performed. Clinical characteristics and treatment modality in form of surgery and radiotherapy (RT) were obtained. Kaplan-Meier survival analysis of progression-free survival (PFS) and overall survival (OS) was performed. ResultsThe median age of the patients was 63.0 years. 20 patients (14.6%) were observed and did not receive any treatment, 74 (54.0%) patients were treated with surgery alone, 33 (24.1%) patients were treated with surgery plus Adjuvant RT and 10 (7.3%) patients only received RT. WHO grade has been shown to have significant impact on OS, with 92, 79 and 0% rate at 5 years for grade I, II and III tumors, respectively (p=0.03). A statistically significant difference in PFS has been demonstrated in patients that underwent gross total versus subtotal resection regardless of the radiation treatment status (p=0.04). Also, we observed a statistically significant advantage in OS (p=0.028) and PFS (p=0.05) in grade II patients who received RT treatment following gross tumor resection. ConclusionsHigh-grade meningiomas are considered more aggressive neoplasms with lower OS and PFS, and histopathological grade is an important prognostic factor. Our study suggests that postoperative adjuvant RT could be considered in all grade II patients, regardless of the degree of resection achieved
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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 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 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".