Diagnostics
Factors Associated with Adjuvant Radiotherapy Use After Simpson Grade I Resection of WHO Grade 2 Meningioma: A Single-Center Retrospective Cohort Study
By Yaşar Ünsal, Mehmet Özgür Özateş, Recai Kulak and 2 others.
Abstract
Background
Adjuvant radiotherapy (RT) after gross-total resection of World Health Organization (WHO) grade 2 meningioma remains an individualized decision in the absence of definitive randomized evidence. We aimed to identify the clinical, radiological, and pathological factors associated with observed adjuvant RT allocation after Simpson grade I resection and to evaluate the discriminatory performance of proliferative biomarkers in real-world multidisciplinary practice.
Methods
This single-center, retrospective cohort included 65 patients, of whom 56 undergoing Simpson grade I resection constituted the primary analytic cohort. Associations with observed RT allocation were evaluated using Firth-penalized logistic regression. Ki-67 and mitotic-index discrimination was summarized using receiver operating characteristic (ROC) analysis, and Ki-67 threshold stability was assessed in 5000 bootstrap resamples. Brain invasion was evaluated in a documented-case sensitivity analysis.