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. 2022 Sep 1;14(17):4285.
doi: 10.3390/cancers14174285.

Low-Dose Acetylsalicylic Acid Treatment in Non-Skull-Base Meningiomas: Impact on Tumor Proliferation and Seizure Burden

Johannes Wach  1 , Ági Güresir  1 , Hartmut Vatter  1 , Ulrich Herrlinger  2 , Albert Becker  3 , Marieta Toma  4 , Michael Hölzel  5 , Erdem Güresir  1
Affiliations

Low-Dose Acetylsalicylic Acid Treatment in Non-Skull-Base Meningiomas: Impact on Tumor Proliferation and Seizure Burden

Johannes Wach et al. Cancers (Basel). .

Abstract

MIB-1 index is an important predictor of meningioma progression and was found to be correlated with COX-2 expression. However, the impact of low-dose acetylsalicylic acid (ASA) on MIB-1 index and clinical symptoms is unclear. Between 2009 and 2022, 710 patients with clinical data, tumor-imaging data, inflammatory laboratory (plasma fibrinogen, serum C-reactive protein) data, and neuropathological reports underwent surgery for primary cranial WHO grade 1 and 2 meningioma. ASA intake was found to be significantly associated with a low MIB-1 labeling index in female patients ≥ 60 years. Multivariable analysis demonstrated that female patients ≥ 60 years with a non-skull-base meningioma taking ASA had a significantly lower MIB-1 index (OR: 2.6, 95%: 1.0-6.6, p = 0.04). Furthermore, the intake of ASA was independently associated with a reduced burden of symptomatic epilepsy at presentation in non-skull-base meningiomas in both genders (OR: 3.8, 95%CI: 1.3-10.6, p = 0.03). ASA intake might have an anti-proliferative effect in the subgroup of elderly female patients with non-skull-base meningiomas. Furthermore, anti-inflammatory therapy seems to reduce the burden of symptomatic epilepsy in non-skull-base meningiomas. Further research is needed to investigate the role of anti-inflammatory therapy in non-skull-base meningiomas.

Keywords: acetylsalicylic acid; aspirin; meningioma; proliferation; seizure.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram displaying the stratification of patients with or without ASA intake in the subgroups of sex and further stratification of female patients by age and elderly females by meningioma location. Statistical results of the independent t-test comparing the mean values and the corresponding standard deviations of the MIB-1 labeling indices are given. Significant statistical results are presented in bold.
Figure 2
Figure 2
Forest plots from multivariable binary logistic regression analysis: Acetylsalicylic acid intake is an independent factor associated with an MIB-1 labeling index <5% in female elderly (≥60 years) non-skull-base meningioma patients. p-values in italics and bold display statistically significant results.
Figure 3
Figure 3
Forest plots from multivariable binary logistic regression analysis: Absence of low-dose ASA intake, male sex, age ≥ 60 years, and tumor area ≥1186.0 mm2 are independent predictors of a preoperative symptomatic epilepsy in non-skull-base meningiomas. p-values in bold and italics display statistically significant results.
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