ArticleNeurosurgical review2021
The role of Simpson grading in meningiomas after integration of the updated WHO classification and adjuvant radiotherapy.
Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resection vs. coagulation of dural attachment in patients with spinal meningioma: an updated systematic review and meta-analysis.Acta neurochirurgica · 2024Pooled it
- Target volume delineation for radiotherapy of meningiomas: an ANOCEF consensus guideline.Radiation oncology (London, England) · 2023Guideline
- Multidisciplinary management of meningiomas in the era of precision oncology.Nature reviews. Clinical oncology · 2026Review
- Influence of dural attachment on remnant progression after subtotal resection in WHO grade 1 meningioma.Acta neurochirurgica · 2025Article
- An evidence-based framework for postoperative surveillance of meningioma.Neuro-oncology practice · 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
- Cranioplasty After Removal of a Meningioma With Skull Invasion: A Technical Case Report.Cureus · 2025Article
- Malignant Meningiomas: From Diagnostics to Treatment.Diagnostics (Basel, Switzerland) · 2025Review
- Review
- Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients.Neuro-oncology · 2024Review
- Preoperative prediction of CNS WHO grade and tumour aggressiveness in intracranial meningioma based on radiomics and structured semantics.Scientific reports · 2024Article
- Unveiling an atypical meningioma amidst stroke symptoms: importance of accurate diagnosis and comprehensive follow-up: A case report.Radiology case reports · 2024Article
- Article
- Scalp metastasis from atypical meningioma: A case report and literature review.Clinical case reports · 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
- Review
- Optic Nerve Sheath Meningiomas: Solving Diagnostic Challenges withDiagnostics (Basel, Switzerland) · 2023Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Since the introduction of the Simpson grading for the extent of resection in meningiomas in 1957, its usefulness in modern neurosurgery has been challenged. Especially, the updated WHO classification regarding brain invasion and the efficacy of radiation therapy has not been taken into account when evaluating the prognostic role of the Simpson grading in this era. We analyzed the clinical and histopathological data of 1571 meningiomas that were surgically resected in the authors' institution between July 2003 and March 2017. Operative reports were reviewed regarding the extent of resection according to Simpson grading. Meningioma subtype according to the updated WHO classification of 2016 and clinical characteristics and time to tumor progression were analyzed. The mean follow-up was 38.4 months (range 1.2 to 195.6). A higher rate of tumor recurrence was observed for male gender, younger age, recurrent tumors, non-spinal tumor localization, higher WHO, and Simpson grades in the univariate analysis. In the multivariate analysis older age, recurrent tumors and higher WHO grades remained negative prognostic factors. Among the different Simpson grades, the relative risk for recurrence was highest for grade IV compared to all other grades (each p < 0.0001), while there was no difference between Simpson grades I and II. Adjuvant radiotherapy showed lower rates of tumor recurrence. Subtotal microsurgical resection remains an independent prognostic factor with a higher rate of tumor recurrence. The prognostic benefit of radical treatment of the dural attachment is questionable and needs to be considered when weighing the intraoperative risks of radicality.
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