Mitotic index is an independent predictor of recurrence-free survival in meningioma

Adriana Olar, Khalida M. Wani, Erik P. Sulman, Seyed Alireza Mansouri, Gelareh Zadeh, Charmaine D. Wilson, Franco Demonte, Gregory N. Fuller, Kenneth D. Aldape

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

While World Health Organization (WHO) grading of meningioma stratifies patients according to recurrence risk overall, there is substantial within-grade heterogeneity with respect to recurrence-free survival (RFS). Most meningiomas are graded according to mitotic counts per unit area on hematoxylin and eosin sections, a method potentially confounded by tumor cellularity, as well as potential limitations of accurate mitotic figure detection on routine histology. To refine mitotic figure assessment, we evaluated 363 meningiomas with phospho-histone H3 (Ser10) and determined the mitotic index (number of mitoses per 1000 tumor cells). The median mitotic indices among WHO grade I (n = 268), grade II (n = 84) and grade III (n = 11) tumors were 1, 4 and 12. Classification and regression tree analysis to categorize cut-offs identified three subgroups defined by mitotic indices of 0-2, 3-4 and ≥5, which on univariate analysis were associated with RFS (P < 0.01). In multivariate analysis, mitotic index subgrouped in this manner was significantly associated with RFS (P < 0.01) after adjustment for Simpson grade, WHO grade and MIB-1 index. Mitotic index was then examined within individual WHO grade, showing that for grade I and grade II meningiomas, mitotic index can add additional information to RFS risk. The results suggest that the use of a robust mitotic marker in meningioma could refine risk stratification.

Original languageEnglish (US)
Pages (from-to)266-275
Number of pages10
JournalBrain Pathology
Volume25
Issue number3
DOIs
StatePublished - May 1 2015

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Mitotic Index
Meningioma
Recurrence
Survival
Neoplasms
Hematoxylin
Eosine Yellowish-(YS)
Mitosis
Histones
Histology
Multivariate Analysis
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Pathology and Forensic Medicine
  • Clinical Neurology

Cite this

Olar, A., Wani, K. M., Sulman, E. P., Mansouri, S. A., Zadeh, G., Wilson, C. D., ... Aldape, K. D. (2015). Mitotic index is an independent predictor of recurrence-free survival in meningioma. Brain Pathology, 25(3), 266-275. https://doi.org/10.1111/bpa.12174
Olar, Adriana ; Wani, Khalida M. ; Sulman, Erik P. ; Mansouri, Seyed Alireza ; Zadeh, Gelareh ; Wilson, Charmaine D. ; Demonte, Franco ; Fuller, Gregory N. ; Aldape, Kenneth D. / Mitotic index is an independent predictor of recurrence-free survival in meningioma. In: Brain Pathology. 2015 ; Vol. 25, No. 3. pp. 266-275.
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Olar, A, Wani, KM, Sulman, EP, Mansouri, SA, Zadeh, G, Wilson, CD, Demonte, F, Fuller, GN & Aldape, KD 2015, 'Mitotic index is an independent predictor of recurrence-free survival in meningioma', Brain Pathology, vol. 25, no. 3, pp. 266-275. https://doi.org/10.1111/bpa.12174

Mitotic index is an independent predictor of recurrence-free survival in meningioma. / Olar, Adriana; Wani, Khalida M.; Sulman, Erik P.; Mansouri, Seyed Alireza; Zadeh, Gelareh; Wilson, Charmaine D.; Demonte, Franco; Fuller, Gregory N.; Aldape, Kenneth D.

In: Brain Pathology, Vol. 25, No. 3, 01.05.2015, p. 266-275.

Research output: Contribution to journalArticle

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AU - Olar, Adriana

AU - Wani, Khalida M.

AU - Sulman, Erik P.

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