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  • Further optimal management is difficult to establish the

    2019-08-16

    Further optimal management is difficult to establish, the role of post-operative radiotherapy as a standard adjuvant treatment remains controversial apart for grade III [3,6,7]. Only a handful studies have investigated the nationwide incidence of meningioma in Europe or elsewhere in the world [[8], [9], [10], [11]]. Epidemiology of tumours is mainly provided by cancer registries, often limited to a designated geographic area and/or not including benign neoplasms, despite international recommendations. In recent years, healthcare databases have been increasingly used for epidemiological purposes. To date, such a research on meningiomas has not been achieved in France. The objectives of this study were to assess the epidemiology of operated meningiomas in France using the National Healthcare database and to compare our findings with published results.
    Material and methods
    Results
    Discussion Meningiomas are very common tumours of the central nervous system, unlike data on their epidemiology as well EPZ-6438 as their risk factors. Management varies significantly according to factors such as clinical presentation, age, tumour location, size, and associated pathology. Treatment options include observation with radiological follow-up, EPZ-6438 therapy, surgery or combinations of these alternatives. Extent of resection is the most powerful factor which correlates to the survival and the relapse but, treatment paradigms vary among surgeons, institutions and countries. Most meningiomas exhibit an indolent behaviour and frequently silent course and, more than 80% are graded benign (I) according to the last WHO classification [1]. However, the overall 5-year survival is less than 70% and declines with the patient’s age [20]. Moreover, for completely removed benign meningiomas the 5-year rate of recurrence is about 20% [21]. Thus, the aggressive course of some meningiomas and the apparent incidence rise should promote further research considerations.
    Conclusion
    Conflict of interest
    Compliance with ethical standards
    Authorship contribution Charles Champeaux: conception and design, acquisition of data, analysis and interpretation of data; drafting the article and revising it critically for important intellectual content, final approval of the version to be published. Joconde Weller: conception and design, acquisition of data, analysis and interpretation of data; drafting the article and revising it critically for important intellectual content, final approval of the version to be published. Sandrine Katsahian: conception and design, final approval of the version to be published.
    Funding
    Acknowledgments
    Introduction APIs are a heterogeneous group comprised of multiple Asian American and Pacific Islander subpopulations. This heterogeneity is reflected in the variation in breast cancer rates across API subpopulations. For example, incidence rates are highest among Japanese and Filipinos in the Asian API group; yet, their rates are 30% lower than that of non-Hispanic Whites [1]. In contrast, Pacific Islander API subpopulations (e.g. Native Hawaiian, Samoan, Guamanian/Chamorro) have higher incidence than each of the Asian American subpopulations. In addition, Native Hawaiians, the largest Pacific Islander subpopulation in the U.S., have higher rates than non-Hispanic Whites [2,3]. Breast cancer mortality rates also vary widely across API subpopulations with rates lower for all Asian American subpopulations, and higher for Pacific Islanders as compared to non-Hispanic Whites [4,5]. Differences in lifestyle, socioeconomic status, immigration patterns, access to care, biology, and genetics [2,6,7] likely contribute to the varied incidence and mortality rates observed for breast cancer among the API subpopulations.