ArticleNeurosurgical review2021
The Simpson grading: defining the optimal threshold for gross total resection in meningioma surgery.
Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 32 citations in OpenAlex.
- Accuracy of Surgeon's Estimate of Gross Total Resection After Endoscopic Endonasal Trans-sphenoidal Surgery for Non-Hormone-Producing Pituitary Macroadenomas: Does It Matter?Neurosurgery practice · 2026Article
- Survival Outcomes and Prognostic Factors in Patients with Meningioma: A Single-Center Study at the Indonesian National Cancer Center Dharmais Hospital (2019-2025).Current oncology (Toronto, Ont.) · 2026Article
- Predictive factors in spinal meningiomas - a comparative analysis with intracranial meningiomas of a high-volume skull and base center.Neurosurgical review · 2026Article
- Pediatric meningioma and seizures: a single-center cohort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- Influence of dural attachment on remnant progression after subtotal resection in WHO grade 1 meningioma.Acta neurochirurgica · 2025Article
- Pediatric meningioma and seizures: A scoping review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Recurrence of Resected Skull Base Meningiomas during Long-term Follow-up: Incidence and Predisposing Factors.Journal of neurological surgery. Part B, Skull base · 2025Article
- Analysis of the Predictability of Postoperative Meningioma Resection Status Based on Clinical Features.Cancers · 2024Article
- Neurosurgical treatment and outcome patterns in patients with meningioma in South Moravian region-a population-based study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Simpson's Grading Scale for WHO Grade I Meningioma Resection in the Modern Neurosurgical Era: Are We Really Asking the Right Question?Journal of neurological surgery. Part B, Skull base · 2024Article
- Grading meningioma resections: the Simpson classification and beyond.Acta neurochirurgica · 2024Review
- Meningioma recurrence: Time for an online prediction tool?Surgical neurology international · 2024Review
- Predictive factors for post operative seizures following meningioma resection in patients without preoperative seizures: a multicenter retrospective analysis.Acta neurochirurgica · 2023Article
- Prognosis and histology of sporadic synchronous and metachronous meningiomas and comparative analyses with singular lesions.Neurosurgical review · 2023Article
- Meningiomas with CNS invasion.Frontiers in neuroscience · 2023Review
- Intracranial meningiomas: an update of the 2021 World Health Organization classifications and review of management with a focus on radiation therapy.Frontiers in oncology · 2023Review
- The NXDC-MEN-301 Study on 5-ALA for Meningiomas Surgery: An Innovative Study Design for the Assessing the Benefit of Intra-Operative Fluorescence Imaging.Brain sciences · 2022Article
- The Simpson Grading: Is It Still Valid?Cancers · 2022Review
- The applicability of established clinical and histopathological risk factors for tumor recurrence during long-term postoperative care in meningioma patients.Neurosurgical review · 2022Article
- Clinical Implications of the Mitotic Index as a Predictive Factor for Malignant Transformation of Atypical Meningiomas.Journal of Korean Neurosurgical Society · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Classification of the extent of resection into gross and subtotal resection (GTR and STR) after meningioma surgery is derived from the Simpson grading. Although utilized to indicate adjuvant treatment or study inclusion, conflicting definitions of STR in terms of designation of Simpson grade III resections exist. Correlations of Simpson grading and dichotomized scales (Simpson grades I-II vs ≥ III and grade I-III vs ≥ IV) with postoperative recurrence/progression were compared using Cox regression models. Predictive values were further compared by time-dependent receiver operating curve (tdROC) analyses. In 939 patients (28% males, 72% females) harboring WHO grade I (88%) and II/III (12%) meningiomas, Simpson grade I, II, III, IV, and V resections were achieved in 29%, 48%, 11%, 11%, and < .5%, respectively. Recurrence/progression was observed in 112 individuals (12%) and correlated with Simpson grading (p = .003). The risk of recurrence/progression was increased after STR in both dichotomized scales but higher when subsuming Simpson grade ≥ IV than grade ≥ III resections (HR: 2.49, 95%CI 1.50-4.12; p < .001 vs HR: 1.67, 95%CI 1.12-2.50; p = .012). tdROC analyses showed moderate predictive values for the Simpson grading and significantly (p < .05) lower values for both dichotomized scales. AUC values differed less between the Simpson grading and the dichotomization into grade I-III vs ≥ IV than grade I-II vs ≥ III resections. Dichotomization of the extent of resection is associated with a loss of the prognostic value. The value for the prediction of progression/recurrence is higher when dichotomizing into Simpson grade I-III vs ≥ IV than into grade I-II vs ≥ III resections.
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