Spheno-Orbital Meningiomas: A 16-Year Surgical Experience.

Spheno-Orbital Meningiomas: A 16-Year Surgical Experience.

World Neurosurg. 2016 Dec 22;:

Authors: Freeman JL, Davern MS, Oushy S, Sillau S, Ormond DR, Youssef AS, Lillehei KO

Abstract
OBJECTIVE: To examine the efficacy of spheno-orbital meningioma (SOM) resection aimed at symptomatic improvement, rather than gross total resection, followed by radiation therapy for recurrence.
METHODS: A retrospective review of all patients having undergone resection by the senior author (KOL) between 2000 and 2016 was performed. Demographics, operative details, post-operative outcomes, recurrence rates and radiation treatment plans were analyzed. Statistical analysis was performed to assess for factors affecting recurrence (Fisher's exact and student's t-test), changes in exophthalmos index (student's t-test) and progression free survival (Kaplan-Meier and log rank).
RESULTS: Twenty-five patients were included. 92% were female. Mean age was 51 years. WHO grade was I (n = 21) and II (n=4). Simpson grade was: I (n = 14), II (n = 3), IV (n = 8). Mean follow-up time was 44.8 months. Proptosis was significantly improved at the 3-6 month postoperative visit (mean ΔEI = 0.15, p<0.05) and at last follow-up (mean ΔEI = 0.13, p<0.05). Visual acuity was either improved or stable in 18/19 patients. There were 12 recurrences; mean time to recurrence was 21.8 months. Increased recurrence rate was significantly associated with younger age. Eight patients received fractionated radiation at time of recurrence. To date, all treated patients are progression free.
CONCLUSION: Among this cohort, surgery provided a lasting improvement in proptosis and improved or stabilized visual deficits. Surgery followed by radiation at recurrence provided excellent tumor control and lends credence to the growing body of literature demonstrating effective control of sub-totally resected skull base meningiomas.

PMID: 28017748 [PubMed - as supplied by publisher]

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