Journal Article Observational Study Epublish
PubMed: 42663731 DOI: 10.1007/s11060-026-05753-7
Variation in meningioma recurrence risk estimates across observational cohorts: the influence of calendar time, WHO classifications, geographical settings, and healthcare systems.
J Neurooncol 179(2)
Authors: Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W McDermott, Fang Wang, Pedro Góes, Manoel Antonio de Paiva Neto … and 26 other authors
Affiliations
- Department of Neurosurgery, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, 2100, Denmark.
- Department of Neurosurgery, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, 2100, Denmark.
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
- Department of Neurosurgery, Division of Neuro-Oncology, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.
- Department of Neurosurgery, Laboratory of Translational Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA.
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Laboratory Centre, Norwegian University of Science and Technology (NTNU), St. Olavs Hospital, Trondheim, NO-7491, Norway.
- Department of Pathology, Laboratory Centre, St. Olavs hospital, Trondheim, NO-7030, Norway.
- Department of Radiation Oncology, Harvard Medical School, Massachusetts General Hospital, Mass General Brigham Cancer Institute, Boston, MA, USA.
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA.
- Pathology Unit, Department of Medical Sciences, University and Città della Salute e della Scienza University Hospital of Turin, Turin, Italy.
- Department of Neurosurgery, University of Münster, Münster, Germany.
- Institute for Neuropathology, University of Münster, Münster, Germany.
- Deparment of Neurosurgery, Clemenshospital Münster, Münster, Germany.
- Department of Neurosurgery, Saitama Medical Center/University, Saitama, Japan.
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.
- Department of Neurosurgery, University Regensburg Medical Center, Regensburg, Germany.
- Department of Neurosurgery, Tokyo Women's Medical University, Adachi Medical Center, Tokyo, Japan.
- Department of Neurosurgery, Athens Medical Center, Athens, Greece.
- EUC Athens Medical School, Athens, Greece.
- Department of Neurosurgery, Bethel Clinic University of Bielefeld Medical Center, Bielefeld, Germany.
- Department of Neurosurgery, Yale School of Medicine Yale New Haven Hospital, Smilow Cancer Hospital, New Haven, USA.
- Department of Neurosurgery, Hospital La Fe, Valencia, Spain.
- Université Paris Cité, Department of Neurosurgery, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
- Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA.
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Radiation Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
- Department of Neurosurgery, University of Wisconsin Medical School & Public Health, Madison, WI, USA.
- Department of Radiation Oncology Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland.
- Division of Neurosurgery, Miami Neuroscience Institute, Miami, FL, USA.
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- Department of Neurosurgery, Federal University of São Paulo, São Paulo, Brazil.
Abstract
PURPOSE
Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables.
RESULTS
Recurrence risk estimates varied across all domains examined. More recent calendar periods were associated with higher predicted recurrence risk, particularly for WHO-2 at 5 years (e.g., ≥ 2013 vs. ≤ 2007: RR 1.60, 95% CI 1.19-2.01). Differences were also observed across healthcare systems and geographical settings despite adjustment. In contrast, recurrence risk estimates were broadly comparable between WHO classification editions (2007 vs. 2016). Cohort-level visualization revealed substantial heterogeneity in follow-up duration, inclusion patterns, and recurrence detection.
CONCLUSIONS
Recurrence risk estimates are not stable across time or settings and are influenced by several patterns, particularly data accrual patterns. Recurrence events are inherently "locked" to the historical context in which they were detected, which may have important implications for developing molecular classifiers using retrospective specimens and clinical trials relying on benchmark established in historical settings. We propose transparent visualization of observational cohort composition and individual-level event timing to improve interpretability and comparability.
MeSH
Classification, Meningioma