Background: Malignant meningiomas (WHO Grade III) are rare, aggressive tumors with poor prognosis and high recurrence rates. Gross total resection (GTR) is the preferred treatment; however, recurrence remains a challenge, especially after subtotal resection (STR). The role of adjuvant radiotherapy (RT) and chemotherapy in improving patient outcomes remains controversial. This systematic review and meta-analysis assessed the impact of surgical extent, adjuvant therapies, and prognostic factors on survival and recurrence of malignant meningiomas. Methods: A systematic review and meta-analysis were conducted using the PubMed, Cochrane Library, and Scopus databases. Eligible studies included retrospective and prospective cohorts, case-control studies, and clinical trials reporting the surgical extent (GTR vs. STR), adjuvant therapy, survival, and recurrence. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias Tool. Meta-analysis was performed using random- and fixed-effects models and heterogeneity was assessed using the I² statistic. Results: Sixteen studies (2,208 patients) met the inclusion criteria. The 5-year overall survival (OS) ranged from 40% to 90%, with GTR significantly improving survival (HR = 0.54, 95% CI: 0.50–0.58, p < 0.00001) [1]. Recurrence rates were lower in GTR cases (50–90% in STR). Adjuvant RT improved progression-free survival (HR = 0.36, 95% CI: 0.18–0.70) in STR patients, but its benefit post-GTR was unclear. Chemotherapy had no significant effect on patient survival [2]. Key prognostic factors included tumor location, patient age, Ki-67 index, and histology [3, 4]. Conclusion: GTR is the strongest predictor of long-term survival, whereas STR requires adjuvant RT for disease control. The role of chemotherapy remains uncertain, necessitating further research into targeted therapies. Standardized treatment protocols and long-term surveillance are essential to improve patient outcomes [5].
Aman, R. Ananda , Amelia, R. , Arqursoy, H. , Pramudya, H. and Fajri, I. (2025). Insights on Survival and Recurrence After Surgery in Malignant Meningiomas: A Systematic Review and Meta-Analysis. Asian Pacific Journal of Cancer Prevention, 26(11), 3931-3938. doi: 10.31557/APJCP.2025.26.11.3931
MLA
Aman, R. Ananda, , Amelia, R. , , Arqursoy, H. , , Pramudya, H. , and Fajri, I. . "Insights on Survival and Recurrence After Surgery in Malignant Meningiomas: A Systematic Review and Meta-Analysis", Asian Pacific Journal of Cancer Prevention, 26, 11, 2025, 3931-3938. doi: 10.31557/APJCP.2025.26.11.3931
HARVARD
Aman, R. Ananda, Amelia, R., Arqursoy, H., Pramudya, H., Fajri, I. (2025). 'Insights on Survival and Recurrence After Surgery in Malignant Meningiomas: A Systematic Review and Meta-Analysis', Asian Pacific Journal of Cancer Prevention, 26(11), pp. 3931-3938. doi: 10.31557/APJCP.2025.26.11.3931
CHICAGO
R. Ananda Aman , R. Amelia , H. Arqursoy , H. Pramudya and I. Fajri, "Insights on Survival and Recurrence After Surgery in Malignant Meningiomas: A Systematic Review and Meta-Analysis," Asian Pacific Journal of Cancer Prevention, 26 11 (2025): 3931-3938, doi: 10.31557/APJCP.2025.26.11.3931
VANCOUVER
Aman, R. Ananda, Amelia, R., Arqursoy, H., Pramudya, H., Fajri, I. Insights on Survival and Recurrence After Surgery in Malignant Meningiomas: A Systematic Review and Meta-Analysis. Asian Pacific Journal of Cancer Prevention, 2025; 26(11): 3931-3938. doi: 10.31557/APJCP.2025.26.11.3931
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