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Prognostic factors of microsurgical treatment of intracranial meningiomas - A multivariate analysis.

ABSTRACT: OBJECTIVE:Peri- and postoperative time course of meningioma patients who had undergone surgical treatment was evaluated to determine prognostic factors of neurological outcome by focusing on preoperative parameters. MATERIAL AND METHODS:A retrospective monocenter analysis was performed including patients who were operated in the Department of Neurosurgery, University Hospital Leipzig, from 2009 to 2015. Data from all patients with histologically confirmed diagnosis of intracranial meningioma treated microsurgically were included in the study. The individual characteristics of the patients, meningiomas and Karnofsky Performance scores (KPS) were analyzed by multivariate tests. RESULTS:Two hundred ninety-four patients with a median age of 61 years (range: 17-89) were included. Preoperative KPS (p < 0.001), skull base as tumor origin and tumor size (p < 0.05) proved to be significantly strong prognostic factors of KPS deterioration one year postoperative by multivariate analysis. According to uni- and bivariate analysis, the following prognostic factors could also be found: preoperative mass displacement, preexisting recurrence and presence of preoperative symptoms. In this study, age had no significant influence on deterioration in patient health state, measured by KPS, one year postoperative. CONCLUSION:Patients generally obtained an improvement in KPS score after microsurgical treatment. The knowledge of prognostic factors can be very helpful in the decision-making process for meningioma treatment of the elderly, particularly to estimate the postoperative outcome and quality of life.

SUBMITTER: Kreßner M

PROVIDER: S-EPMC6191082 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Prognostic factors of microsurgical treatment of intracranial meningiomas - A multivariate analysis.

Kreßner Maika M Arlt Felix F Riepl Wolf W Meixensberger Jürgen J

PloS one 20181016 10

<h4>Objective</h4>Peri- and postoperative time course of meningioma patients who had undergone surgical treatment was evaluated to determine prognostic factors of neurological outcome by focusing on preoperative parameters.<h4>Material and methods</h4>A retrospective monocenter analysis was performed including patients who were operated in the Department of Neurosurgery, University Hospital Leipzig, from 2009 to 2015. Data from all patients with histologically confirmed diagnosis of intracranial ...[more]

PMID: 30325925

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Project description:PurposeStereotactic radiosurgery (SRS) has been increasingly used to treat intracranial pathologies in elderly patients. The treatment efficiency of SRS has been demonstrated in meningiomas, with excellent local control. We aimed to analyze the safety of robotic SRS in elderly patients with meningiomas.MethodsWe searched for patients with suspected WHO °I meningioma ≥ 60 years old, who underwent CyberKnife (CK) SRS from January 2011 to December 2021. Tumor localization was categorized using the "CLASS" algorithmic scale. Tumor response was evaluated using the Response Assessment in Neuro-Oncology (RANO) criteria for meningiomas. Adverse effects were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and a cox regression was performed to investigate possible predictors.ResultsWe identified 82 patients with 102 CK-treated lesions that matched the criteria for the first SRS. The median age was 70 [IQR 64-75] years, and 24.3% of the patients were aged > 75 years. Multiple lesions (up to six) were treated in 14.1% of the SRS-sessions. A previous surgery was performed in 57.3% of lesions, with a median time interval of 41 [IQR 10 - 58] months between the initial surgical procedure and the SRS treatment. In 47.9% of cases, CLASS 3 meningiomas at high-risk locations were irradiated. Single fraction radiosurgery was applied to 62.5% of the lesions, while in the remaining cases multi-session SRS with three to five fractions was used. During the median follow-up period of 15.9 months, lesion size progression was observed in 3 cases. Karnofsky Performance Status (KPS) declined by ≥ 20 points in four patients. Adverse effects occurred in 13 patients, while only four patients had CTCAE ≥2 toxicities. Hereby only one of these toxicities was persistent. The occurrence of complications was independent of age, planned target volume (PTV), high-risk localization, and surgery before SRS.ConclusionThe data indicates that SRS is a safe, efficient, and convenient treatment modality for elderly patients with meningioma, even at high-risk locations.

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Prognostic factors of microsurgical treatment of intracranial meningiomas - A multivariate analysis.

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Prognostic factors of microsurgical treatment of intracranial meningiomas - A multivariate analysis.

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