Correlation between cytogenetic and clinical findings in 215 human meningiomas.

The management of meningiomas remains a major challenge to the neurosurgeon because patients having this common benign tumor can be cured effectively by surgical resection. But there are a number of meningiomas that have an aggressive course and tend to recur. Predicting the recurrence of meningiomas has often been mentioned in the context of histology or surgical techniques and some approaches considered. However, the recurrence rate remains between 10% and 20%, even after total removal. To improve the care of patients with problematic meningiomas, 215 different human meningiomas were collected between 1976 and 1993 and cytogenetically analyzed using standard techniques. 140 patients could be observed for 1 to 17 years after complete tumor removal, whereby 21 tumors (15%) displayed one or more recurrences during that long-term observation period. The tumors were classified according to different clonal abnormalities: we observed recurrence in 10 (9.1%) of 111 (79.2%) tumors having a normal karyotype or typical monosomy of chromosome 22, whereas 9 (69.7%) of 13 tumors with pronounced hypodiploidy and 3 (35%) of 8 tumors with a hyperdiploid karyotype recurred. A loss of the short arm of chromosome 1 was identified in 6 meningiomas with a recurrence rate of 60%. Our observations show that the correlation between meningiomas and recurrence is highly significant (p = 0.002) and that these tumors require special treatment in addition to surgical skill.