Patient-derived ex vivo cell culture growth dynamics predict recurrence probability in patients with atypical and anaplastic meningiomas

Purpose: The prediction of recurrence in meningiomas is limited by the lack of ex vivo meningioma models. By introducing a novel patient-derived ex vivo cell culture model, we aimed to utilize cell growth dynamics to predict recurrence patterns. Methods Tissue samples were collected from patients who underwent meningioma resection at our department between April 2021 and November 2021 immediately after tissue harvesting. After establishing a novel cell culture procedure in a modified DMEM medium, histopathological analysis, and immunohistochemistry were performed. Population doubling time and cell growth rate were measured during the 38-day observational period. The mean clinical follow-up was 18 months. Clinical and radiological examinations were conducted before surgery and three and 15 months after tumor resection. Results A patient-derived ex vivo cell culture model was successfully established for 21 of 29 samples of central nervous system-World Health Organization (WHO) grade 1–3 meningiomas. The population doubling time and two-week ex vivo model survival differed significantly among malignancy grades ( p  = 0.010). Viability at the second week of culture correlated with WHO grade ( p  = 0.024). A positive population doubling time at the second week and a population doubling time of < 200 hours were correlated with relapsing disease within 15 months ( p  = 0.013). Conclusion As early as the end of the second week of cell culture, growth dynamics may provide prognosis data for atypical and anaplastic meningiomas. Further studies of cell growth patterns may support therapeutic decisions in patients with meningiomas when molecular analysis cannot be performed.