World Neurosurg. 2022 Apr 16:S1878-8750(22)00496-X. doi: 10.1016/j.wneu.2022.04.048. Online ahead of print.
ABSTRACT
BACKGROUND: It has been proposed in the most recent 2021 World Health Organization (WHO) Classification of brain tumors that the loss of trimethylation at histone 3 lysine site 27 (H3K27me3) may prognosticate meningioma outcomes. However to date the emerging literature remains diffuse in its stance on this. Correspondingly, the aim of this study was to determine the prognostic relevance of H3K27me3 loss in meningiomas METHODS: Searches of 7 electronic databases from inception to October 2021 were conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. Outcomes were pooled by random-effects meta-analyses of proportions where possible.
RESULTS: A total of 7 retrospective cohort studies satisfied all criteria. There were 2180 meningioma patients overall, with 1291 (59%) male patients, and a mean age of 56 years old. Across all 7 studies, the pooled incidence of H3K27me3 loss was estimated to be 15% (95% CI 8-24%). Across 6 studies the pooled multivariate-derived HR estimate for recurrence was 1.77 (95% CI 1.23-2.31, P<0.01). Overall survival by univariate analysis was significantly shorter with H3K27me3 loss in 2/4 (50%) studies, and 2 studies described significant association between H3K27me3 loss and shorter overall survival by means of multivariate analysis.
CONCLUSION: The contemporary metadata favors greater recurrence of meningioma based independently on H3K27me3 loss that is statistically significant. It is possible that these effects are more pronounced in Grade 2 meningiomas, but more robust data and analysis is needed to augment this position.
PMID:35439620 | DOI:10.1016/j.wneu.2022.04.048
