CMRG

SHORT INTRODUCTION

We strive to develop and improve personal surgery services for patients with meningioma. Our focus is on developing pre-operative imaging, radioactive image markers and increase our understanding of peritumoral edema, inflammation, epilepsy and cognitive dysfunctions in relation to the patient’s final outcome. Our goal is to develop better, safer surgical and medical treatments with a greater degree of total removal and thereby complete recovery from the disease.

 

BACKGROUND AND AIM

In around 23 per 100,000 people, new brain tumors are diagnosed annually. The commonest tumors, meningioma, are considered benign, but long-term mortality can reach 50% and postsurgical long term morbidity 40-50%. Bad outcomes depend on recurrences and considerable cognitive, emotional and neurological morbidity that affect coping and recovery. Today, therapy is standardized and primarily based on a few basic MRI-imaging features where individual tumor and patient qualities are not considered.

Better and personalized management of meningioma patients is an important therapeutic goal. In management of meningioma patients, survival alone should no longer be the sole endpoint, but instead quality of survival must be considered.

In current practice meningiomas are crudely classified per WHO 2016 classification, which does not support effectively targeted chemotherapy or individualized management, accounting for tumor biology, prevention of recurrences or individual outcome regarding health; Subjective coping, neuropsychiatric problems and management of epilepsy.

Genetic analyses indicate special roles for specific mutations in aggressive behavior and as driving forces in tumor genesis. We lack reproducible and relevant means to classify the extent of resection and there is a lack of reliable histopathological markers for free resection margins and higher specificity of imaging is needed.

The collateral damage caused by edema and inflammation, induced by the tumor and perhaps also surgery in addition or by itself, is thought to cause epilepsy and also negatively impact cognition, emotion and coping capabilities, resulting in a poorer outcome. The pathophysiology is not well understood and nothing in the current treatment offers evaluation on the degree or treatment of the inflammation.

We intend to collect observational data on the occurrence of psychological symptoms, neuroinflammation, epilepsy and coping to search mechanistic explanations in covariation, to identify predictors for targeted psychological or therapeutic interventions and to improve recovery and coping.

The individualized management we strive to incorporate includes:

  • Imaging
  • Neuropsychology (cognition, emotion, coping)
  • Neuroinflammation
  • Histopathology
  • Evaluation of sequelae (epilepsy, neurological deficits)
You can see the current projects under the projects list available here, and typing 'meningioma' in the search bar.