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1000 Titel
  • The Simpson grading: defining the optimal threshold for gross total resection in meningioma surgery
1000 Autor/in
  1. Brokinkel, Benjamin |
  2. Spille, Dorothee Cäcilia |
  3. Brokinkel, Caroline |
  4. Hess, Katharina |
  5. Paulus, Werner |
  6. Bormann, Eike |
  7. Stummer, Walter |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-08-18
1000 Erschienen in
1000 Quellenangabe
  • 44(3):1713-1720
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s10143-020-01369-1 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397672/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Classification of the extent of resection into gross and subtotal resection (GTR and STR) after meningioma surgery is derived from the Simpson grading. Although utilized to indicate adjuvant treatment or study inclusion, conflicting definitions of STR in terms of designation of Simpson grade III resections exist. Correlations of Simpson grading and dichotomized scales (Simpson grades I-II vs ≥ III and grade I-III vs ≥ IV) with postoperative recurrence/progression were compared using Cox regression models. Predictive values were further compared by time-dependent receiver operating curve (tdROC) analyses. In 939 patients (28% males, 72% females) harboring WHO grade I (88%) and II/III (12%) meningiomas, Simpson grade I, II, III, IV, and V resections were achieved in 29%, 48%, 11%, 11%, and < .5%, respectively. Recurrence/progression was observed in 112 individuals (12%) and correlated with Simpson grading (p = .003). The risk of recurrence/progression was increased after STR in both dichotomized scales but higher when subsuming Simpson grade ≥ IV than grade ≥ III resections (HR: 2.49, 95%CI 1.50-4.12; p < .001 vs HR: 1.67, 95%CI 1.12-2.50; p = .012). tdROC analyses showed moderate predictive values for the Simpson grading and significantly (p < .05) lower values for both dichotomized scales. AUC values differed less between the Simpson grading and the dichotomization into grade I-III vs ≥ IV than grade I-II vs ≥ III resections. Dichotomization of the extent of resection is associated with a loss of the prognostic value. The value for the prediction of progression/recurrence is higher when dichotomizing into Simpson grade I-III vs ≥ IV than into grade I-II vs ≥ III resections.
1000 Sacherschließung
lokal Aged, 80 and over [MeSH]
lokal Neoplasm Grading [MeSH]
lokal Recurrence
lokal Aged [MeSH]
lokal World Health Organization [MeSH]
lokal Neoplasm Recurrence, Local/surgery [MeSH]
lokal Original Article
lokal Meningeal Neoplasms/surgery [MeSH]
lokal Male [MeSH]
lokal Meningioma/surgery [MeSH]
lokal Meningioma/diagnosis [MeSH]
lokal Neoplasm Recurrence, Local/diagnosis [MeSH]
lokal Child [MeSH]
lokal Neurosurgical Procedures/standards [MeSH]
lokal Meningiomas
lokal Adolescent [MeSH]
lokal Female [MeSH]
lokal Follow-Up Studies [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Microsurgery
lokal Simpson grading
lokal Progression
lokal Retrospective Studies [MeSH]
lokal Middle Aged [MeSH]
lokal Meningeal Neoplasms/diagnosis [MeSH]
lokal Neurosurgical Procedures/methods [MeSH]
lokal Young Adult [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0003-3462-3479|https://frl.publisso.de/adhoc/uri/U3BpbGxlLCBEb3JvdGhlZSBDw6RjaWxpYQ==|https://frl.publisso.de/adhoc/uri/QnJva2lua2VsLCBDYXJvbGluZQ==|https://frl.publisso.de/adhoc/uri/SGVzcywgS2F0aGFyaW5h|https://frl.publisso.de/adhoc/uri/UGF1bHVzLCBXZXJuZXI=|https://frl.publisso.de/adhoc/uri/Qm9ybWFubiwgRWlrZQ==|https://frl.publisso.de/adhoc/uri/U3R1bW1lciwgV2FsdGVy
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1000 Erstellt am 2023-11-18T07:12:02.651+0100
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