Meningiomas Adjacent to Major Venous Sinuses -clinical Outcome and Recurrence.

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Meningiomas Adjacent to Major Venous Sinuses -clinical Outcome and Recurrence.

World Neurosurg. 2017 May 13;:

Authors: Anthofer J, Seidel-Schulz R, Brawanski A, Schebesch KM

Abstract
INTRODUCTION: Surgical treatment of meningiomas next to venous sinuses is difficult because of their irregular growth patterns and infiltration into the venous sinuses, therefore making gross total resection impossible in some patients. In this study, we evaluated the postoperative clinical and neurological course of this tumor subgroup.
METHODS: This study included 141 consecutive patients with meningioma located within 20 mm to a major venous sinus. We reviewed patient charts and surgical reports for demographics, histology, and clinical and neurological performance pre- and postoperatively and during follow-up. Radiographic images were screened for tumor extension, infiltration into the skull, sinus infiltration (Sindou grade), extent of resection (EOR; Simpson grade), and tumor recurrence.
RESULTS: 141 patients with complete data sets were included. Immediate postoperative neurological improvement was found in 53.7% (n=36) of patients with preoperative neurological deficits (n=67). Follow-up was up to 13.5 years. The MRCNPS (Medical Research Council-Neurological Performance Status) had postoperatively improved in 24.1% of patients and the KPS (Karnofsky Performance Score) in 55.3%. Local tumor recurrence was detected in 10.6% (n=15) of patients. Higher WHO grades (p=0.03), tumor size (p=0.001) and bone invasion (p=0.002) presented as predictors of local tumor recurrence. The median MIB-1 labeling index in patients with tumor recurrence was twice as high as in patients without recurrence.
CONCLUSION: Surgical removal of meningiomas adjacent to venous sinuses reduces neurological impairment and enables local tumor control in the majority of patients. Tumor size, bone infiltration, and higher WHO grades are important predictors of tumor recurrence.

PMID: 28512040 [PubMed - as supplied by publisher]

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