Long-term outcome of Simpson IV meningioma resection: Would it improve with adjuvant SRS?

0552206 - ÚI 2022 RIV NL eng J - Journal Article
Dedeciusová, M. - Majovský, M. - Pecen, Ladislav - Beneš, V. - Netuka, D.
Long-term outcome of Simpson IV meningioma resection: Would it improve with adjuvant SRS?
Clinical Neurology and Neurosurgery. Roč. 207, August 2021 (2021), č. článku 106766. ISSN 0303-8467. E-ISSN 1872-6968
Institutional support: RVO:67985807
Keywords : Meningioma * Simpson grade * Stereotactic * Radiation * Oncology
OECD category: Clinical neurology
Impact factor: 1.885, year: 2021
Method of publishing: Limited access
http://dx.doi.org/10.1016/j.clineuro.2021.106766

Objective: Subtotal meningioma resection (STR) is often performed to minimize surgical morbidity. Nevertheless, only a few studies have reported on patient outcome after STR. We studied the long-term outcome of SIV (Simpson grade IV) resection and identified predictive factors of overall survival (OS), progression-free survival (PFS) and time to progression (TTP). Methods: A retrospective analysis was performed on 68 patients who underwent SIV resection of meningioma (grade I) from 2004 to 2010. Data were collected from clinical, surgical and pathology records and radiological imaging. Long-term outcomes were evaluated at least 10 years after surgery. Results: Permanent morbidity was 11.8%, 30-day mortality 2.9% and progression rate 50.0% for a median followup duration of 126.6 months. Median TTP was 86.2 months. Adjuvant SRS was the only significant factor associated with longer PFS (p = 0.0052) and TTP (p = 0.0079). Higher age (p = 0.0022), KPS (p = 0.0182), postoperative ECOG score (p = 0.0182) were reliable predictors of shortened OS and aSRS (p = 0.0445) was reliable predictor of longer OS. Conclusion: STR in intracranial meningioma is still viable and often the only treatment option available in high risk patients or high-risk tumors. Although surgical morbidity and mortality are high, the OS rate was 85.3% at 5 years and 79.4% at 10 years. Because of the considerable progression rate and rather a long term OS the adjuvant SRS should be considered following SIV resection.
Permanent Link: http://hdl.handle.net/11104/0327341