Variation in meningioma recurrence risk estimates across observational cohorts: the influence of calendar time, WHO classifications, geographical settings, and healthcare systems

PURPOSE: Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables. RESULTS: Recurrence risk estimates varied across all domains examined. More recent calendar periods were associated with higher predicted recurrence risk, particularly for WHO-2 at 5 years (e.g., ≥ 2013 vs. ≤ 2007: RR 1.60, 95% CI 1.19-2.01). Differences were also observed across healthcare systems and geographical settings despite adjustment. In contrast, recurrence risk estimates were broadly comparable between WHO classification editions (2007 vs. 2016). Cohort-level visualization revealed substantial heterogeneity in follow-up duration, inclusion patterns, and recurrence detection. CONCLUSIONS: Recurrence risk estimates are not stable across time or settings and are influenced by several patterns, particularly data accrual patterns. Recurrence events are inherently "locked" to the historical context in which they were detected, which may have important implications for developing molecular classifiers using retrospective specimens and clinical trials relying on benchmark established in historical settings. We propose transparent visualization of observational cohort composition and individual-level event timing to improve interpretability and comparability.

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Journal
Journal of Neuro-Oncology
Published
2026-08-28
DOI
https://doi.org/10.1007/s11060-026-05753-7
Primary Topic
Meningioma and schwannoma management
Type
article
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article

Variation in meningioma recurrence risk estimates across observational cohorts: the influence of calendar time, WHO classifications, geographical settings, and healthcare systems

Ricardo Prat-Acín, Soichi Oya, Tamás Csonka, Matthew Koshy et al.
Journal of Neuro-Oncology
Meningioma and schwannoma management
article

Variation in meningioma recurrence risk estimates across observational cohorts: the influence of calendar time, WHO classifications, geographical settings, and healthcare systems

Ricardo Prat-Acín, Soichi Oya, Tamás Csonka, Matthew Koshy, Junkoh Yamamoto, Jacob S. Young, Tony Catalan, Ian G. Law, Tiit Illimar Mathiesen, John Ta-Hsiang Tsiang, Jong Hee Chang, Chang‐Ok Suh, Satoru Miyawaki, Ilker Y. Eyüpoglu, Yasuhiro Kuroi, Young Zoon Kim, Dorothee Cäcilia Spille, Tina Nørgaard Munch, Vikram C. Prabhu, Bjarne Winther Kristensen, Luís Souhami, Luca Bertero, Matthias Simon, Konstantinos Gousias, Daniel W. Kim, Tiemo Jürgen Klisch, Dennis C. Shrieve, Benjamin Brokinkel, Evan Luther, Philip V. Theodosopoulos, Stephen T. Magill, Helen Alice Shih, Nobuhito Saito, Andrea Daniela Maier, Simon Skyrman, Maria Kamenova, Michael E. Ivan, Manoel Antônio de Paiva Neto, Lasse Rehné Jensen, Sven Straumann, SVERRE HELGE TORP, Tareq Adnan Juratli, Christian Mirian, Kåre Fugleholm, Akash J. Patel, Austin Lui, Torstein Ragnar Meling, Stéphane Goutagny, Anders Broechner, Joo Ho Lee, Karthikeyan Perumal, Donald M. Cannon, Olivia Claire Barrett, Adam Gorm Hoffmann, Ricardo Komotar, Ramin A. Morshed, Jennifer Moliterno, Paul Blanche, Aria Jamshidi, Toshiki Endo, Jehuda Soleman, Erdem Güresir, Randy Jensen, Johannes Wach, Marie-Christine Guiot, Pedro Góes, Michael W. McDermott, María Dolores Tabernero, Fang Wang, Francesco Maiuri, Martin Proescholdt, Valeria Barresi, Walter Stummer, Mustafa K. Baskaya, Tejpal Gupta, Jun Won Kim
article en

Abstract

PURPOSE: Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables. RESULTS: Recurrence risk estimates varied across all domains examined. More recent calendar periods were associated with higher predicted recurrence risk, particularly for WHO-2 at 5 years (e.g., ≥ 2013 vs. ≤ 2007: RR 1.60, 95% CI 1.19-2.01). Differences were also observed across healthcare systems and geographical settings despite adjustment. In contrast, recurrence risk estimates were broadly comparable between WHO classification editions (2007 vs. 2016). Cohort-level visualization revealed substantial heterogeneity in follow-up duration, inclusion patterns, and recurrence detection. CONCLUSIONS: Recurrence risk estimates are not stable across time or settings and are influenced by several patterns, particularly data accrual patterns. Recurrence events are inherently "locked" to the historical context in which they were detected, which may have important implications for developing molecular classifiers using retrospective specimens and clinical trials relying on benchmark established in historical settings. We propose transparent visualization of observational cohort composition and individual-level event timing to improve interpretability and comparability.

Journal of Neuro-OncologyVol. 179(2)
Statens Serum Institut (DK), Northwestern University (US), University of Verona (IT), University of Copenhagen (DK), Loyola University Medical Center (US), Yale New Haven Hospital (US), University of Debrecen (HU), University of Wisconsin–Madison (US), Harvard University (US), Seoul National University (KR), University of California, San Francisco (US), Baylor College of Medicine (US), University of Occupational and Environmental Health Japan (JP), Yonsei University (KR), Université Paris Cité (FR), Norwegian University of Science and Technology (NO), University of Utah (US), University of Münster (DE), Samsung (South Korea) (KR), Hôpital Beaujon (FR), Tata Memorial Hospital (IN), Allegheny General Hospital (US), Huntsman Cancer Institute (US), McGill University Health Centre (CA), University Hospital of Basel (CH), Copenhagen University Hospital (DK), Rigshospitalet (DK), Seoul National University Hospital (KR), Karolinska Institutet (SE), University Hospital Regensburg (DE), University of Illinois Chicago (US), Massachusetts General Hospital (US), Assistance Publique – Hôpitaux de Paris (FR), St Olav's University Hospital (NO), University of Tokyo Hospital (JP), Department of Medical Sciences (RU), Neurological Research Institute (US), Leitat Technological Center (ES), Mobile Infirmary (US), University of Illinois Hospital & Health Sciences System (US), University Hospital Leipzig (DE), Athens Medical Center (GR), Clemenshospital Münster (DE), Instituto de Investigación Biomédica de Salamanca (ES), Tokyo Women's Medical University Adachi Medical Center (JP), Tokyo Women's Medical University (JP), Gangnam Severance Hospital (KR), Texas Children's Hospital (US), Hackensack Meridian Health (US), First Affiliated Hospital of Zhengzhou University (CN), Sylvester Comprehensive Cancer Center (US), Advanced Centre for Treatment, Research and Education in Cancer (IN), Neurological Surgery (US), Social Insurance Saitama Chuo Hospital (JP), University Hospital Carl Gustav Carus (DE), Fondazione IRCCS Istituto Neurologico Carlo Besta (IT), Smilow Cancer Hospital (US), University of Naples Federico II (IT), Sungkyunkwan University (KR), Tohoku Medical and Pharmaceutical University (JP), Saitama Medical University (JP), Universidade Federal de São Paulo (BR)
Cancer Prevention and Research Institute of Texas, Texas Children's Hospital, Fondazione Ricerca Molinette, H. Lundbeck A/S
Reduced inequalities
Openalex Percentile: Top 10%
Meningioma and schwannoma management
DOIOpen Access PDFOpenAlex
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