The research includes clinical and histological evaluations of around 1000 meningioma patients, as well as 3D tumour volumetry on postoperative MRI in over 400 cases. The researchers looked at the predictive relevance of tumour remnants on postoperative MRI for recurrence development. It begs the question of whether intraoperative assessment of resection extent is still the gold standard in surgery.The Simpson grading system is used to evaluate the probability of postoperative recurrence in meningiomas, however it is subject to bias and has a limited view of the resection cavity. The importance of postoperative tumour volume as an objective predictor of recurrence is mainly unknown. The purpose of this study was to compare the predictive value of residual tumour volume with the extent of the tumour as determined intraoperatively.

In 423 patients (45%) with available imaging, residual tumor volume covered a broad range (0–78.5 cm3) MRI revealed tumor remnants in 8% after gross-total resection (Simpson grade I–III, range 0.12–33.5cm3) Postoperative tumor volume was correlated with recurrence in univariate analysis (HR 1.05 per cm3, 95% CI 1.02–1.08), p < 0.001. Recurrence correlated with Simpson grading (p = 0.003). After surgery for an intracranial meningioma, the Simpson grade was assessed in 939 individuals. Within 6 months of surgery, the tumour volume was evaluated on an initial postoperative MRI. A tree-structured Cox regression model was used to compare the correlation between both variables and recurrence.

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