Background: While several risk factors for recurrences have been defined, the topographic pattern of meningioma recurrences after surgical resection has been scarcely investigated. The possibility of theoretically predicting the site of recurrence not only allows us to better understand the pathogenetic bases of the disease and consequently to drive the development of new targeted therapies, but also guides the decision-making process for treatment strategies and tailored follow-ups to decrease/prevent recurrence. Methods: The authors performed a comprehensive and detailed systematic literature review of the EMBASE and MEDLINE electronic online databases regarding the topographic pattern of recurrence after surgical treatment for intracranial meningiomas. Demographics and histopathological, neuroradiological and treatment data, pertinent to the topography of recurrences, as well as time to recurrences, were extracted and analyzed. Results: Four studies, including 164 cases of recurrences according to the inclusion criteria, were identified. All studies consider the possibility of recurrence at the previous dural site; three out of four, which are the most recent, consider 1 cm outside the previous dural margin to be the main limit to distinguish recurrences closer to the previous site from those more distant. Recurrences mainly occur within or close to the surgical bed; higher values of proliferation index are associated with recurrences close to the original site rather than within it. Conclusions: Further studies, including genomic characterization of different patterns of recurrence, will better clarify the main features affecting the topography of recurrences. A comparison between topographic classifications of intracranial meningioma recurrences after surgery and after radiation treatment could provide further interesting information.
背景：尽管已确定多种复发风险因素，但关于脑膜瘤手术切除后复发部位分布模式的研究仍较为有限。理论上预测复发部位的可能性不仅有助于我们更深入地理解该疾病的发病机制，从而推动新型靶向疗法的研发，还能为制定个体化治疗策略和随访方案提供指导，以降低或预防复发。 方法：作者对EMBASE和MEDLINE电子数据库中关于颅内脑膜瘤手术治疗后复发部位分布模式的文献进行了全面系统的回顾。提取并分析了与复发部位相关的人口统计学、组织病理学、神经影像学及治疗数据，同时记录了复发时间。 结果：根据纳入标准，共筛选出四项研究，涵盖164例复发案例。所有研究均考虑了原硬脑膜部位复发的可能性；其中三项最新研究提出以原硬脑膜边缘外1厘米作为区分近端复发与远端复发的主要界限。复发主要发生在手术区域内部或邻近区域；较高的增殖指数与邻近原发部位的复发（而非原位复发）具有相关性。 结论：未来研究（包括对不同复发模式的基因组学特征分析）将更清晰地阐明影响复发部位分布的关键因素。比较手术与放射治疗后颅内脑膜瘤复发的部位分类模式，可能为临床提供更多有价值的信息。
肿瘤(癌症)患者之家