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Li H, Zheng D, Wang Y, Ying Y, Sui D, Lin S, Jiang Z, Huang H, Zhang G. Decision-making tree for surgical treatment in meningioma: a geriatric cohort study. Neurosurg Rev 2023; 46:196. [PMID: 37555964 DOI: 10.1007/s10143-023-02103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 08/10/2023]
Abstract
Controversies persist regarding the benefits of surgery in elderly patients with meningiomas. The objective of this study was to develop decision-making scale to clarify the necessity for surgical intervention and provide clinical consultation for this special population. This retrospective cohort study was conducted at a single center and included 478 elderly patients (≥ 65 years) who underwent meningioma resection. Follow-up was recorded to determine recurrence and mortality rates. Univariate and multivariate analyses were performed to identify significantly preoperative factors, and prognostic prediction models were developed with determined cutoff values for the prognostic index (PI). Model discrimination was evaluated using Kaplan-Meier curves based on the PI stratification, which categorized patients into low- and high-risk groups. A decision-making tree was then established based on the risk stratification from both models. Among all patients analyzed (n = 478), 62 (13.0%) experience recurrence and 47 (10.0%) died during the follow-up period. Significantly preoperative parameters from both models included advanced age, aCCI, recurrent tumor, motor cortex involvement, male sex, peritumoral edema, and tumor located in skull base (all P < 0.05). According to the classification of PI from the two models, the decision-making tree provided four recommendations that can be used for clinical consultation. Surgery is not recommended for patients assigned to the high-risk group in both models. Patients who meet the low-risk criteria in any model may undergo surgical intervention, but the final decision should depend on the surgeon's expertise.
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Affiliation(s)
- Haoyi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Yonggang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Yuzhe Ying
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Dali Sui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China
| | - Huawei Huang
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China.
| | - Guobin Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China.
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Gousias K, Trakolis L, Simon M. Meningiomas with CNS invasion. Front Neurosci 2023; 17:1189606. [PMID: 37456997 PMCID: PMC10339387 DOI: 10.3389/fnins.2023.1189606] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
CNS invasion has been included as an independent criterion for the diagnosis of a high-grade (WHO and CNS grade 2 and 3) meningioma in the 2016 and more recently in the 2021 WHO classification. However, the prognostic role of brain invasion has recently been questioned. Also, surgical treatment for brain invasive meningiomas may pose specific challenges. We conducted a systematic review of the 2016-2022 literature on brain invasive meningiomas in Pubmed, Scopus, Web of Science and the Cochrane Library. The prognostic relevance of brain invasion as a stand-alone criterion is still unclear. Additional and larger studies using robust definitions of histological brain invasion and addressing the issue of sampling errors are clearly warranted. Although the necessity of molecular profiling in meningioma grading, prognostication and decision making in the future is obvious, specific markers for brain invasion are lacking for the time being. Advanced neuroimaging may predict CNS invasion preoperatively. The extent of resection (e.g., the Simpson grading) is an important predictor of tumor recurrence especially in higher grade meningiomas, but also - although likely to a lesser degree - in benign tumors, and therefore also in brain invasive meningiomas with and without other histological features of atypia or malignancy. Hence, surgery for brain invasive meningiomas should follow the principles of maximal but safe resections. There are some data to suggest that safety and functional outcomes in such cases may benefit from the armamentarium of surgical adjuncts commonly used for surgery of eloquent gliomas such as intraoperative monitoring, awake craniotomy, DTI tractography and further advanced intraoperative brain tumor visualization.
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Affiliation(s)
- Konstantinos Gousias
- Department of Neurosurgery, St. Marien Academic Hospital Lünen, KLW St. Paulus Corporation, Luenen, Germany
- Medical School, Westfaelische Wilhelms University of Muenster, Muenster, Germany
- Medical School, University of Nicosia, Nicosia, Cyprus
| | - Leonidas Trakolis
- Department of Neurosurgery, St. Marien Academic Hospital Lünen, KLW St. Paulus Corporation, Luenen, Germany
| | - Matthias Simon
- Department of Neurosurgery, Bethel Clinic, Medical School, Bielefeld University, Bielefeld, Germany
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Corniola MV, Meling TR. Management of Recurrent Meningiomas: State of the Art and Perspectives. Cancers (Basel) 2022; 14:cancers14163995. [PMID: 36010988 PMCID: PMC9406695 DOI: 10.3390/cancers14163995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Intracranial meningiomas account for 30% to 40% of the primary lesions of the central nervous system. Surgery is the mainstay treatment whenever symptoms related to an intra-cranial meningioma are encountered. However, the management of recurrences after initial surgery, which are not uncommon, is still a matter of debate. Here, we present the alternatives described in the management of meningioma recurrence (radiotherapy, stereotaxic radiosurgery, protontherapy, and chemotherapy, among others). Their overall results are compared to surgery and future perspectives are presented. Abstract Background: While meningiomas often recur over time, the natural history of repeated recurrences and their management are not well described. Should recurrence occur, repeat surgery and/or use of adjuvant therapeutic options may be necessary. Here, we summarize current practice when it comes to meningioma recurrence after initial surgical management. Methods: A total of N = 89 articles were screened. N = 41 articles met the inclusion criteria and N = 16 articles failed to assess management of meningioma recurrence. Finally, N = 24 articles were included in our review. Results: The articles were distributed as follows: studies on chemotherapy (N = 14), radiotherapy, protontherapy, and stereotaxic radiosurgery (N = 6), boron-neutron capture therapy (N = 2) and surgery (N = 3). No study seems to provide serious alternatives to surgery in terms of progression-free and overall survival. Recurrence can occur long after the initial surgery and also affects WHO grade 1 meningiomas, even after initial gross total resection at first surgery, emphasizing the need for a long-term and comprehensive follow-up. Conclusions: Surgery still seems to be the state-of-the-art management when it comes to meningioma recurrence, since none of the non-surgical alternatives show promising results in terms of progression-free and overall survival.
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Affiliation(s)
- Marco Vincenzo Corniola
- Service de Neurochirurgie, Pôle des Neurosciences, Centre Hospitalier Universitaire de Rennes, 35000 Rennes, France
- Faculté de Médecine, Université de Rennes 1, 35000 Rennes, France
- Faculté de Médecine, Université de Genève, 1205 Geneve, Switzerland
- Laboratoire du Traitement de Signal, Unité Médicis, INSERM UMR 1099 LTSI, Université de Rennes 1, 35000 Rennes, France
| | - Torstein R. Meling
- Faculté de Médecine, Université de Genève, 1205 Geneve, Switzerland
- Department of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland
- Besta NeuroSim Center, Fondazione IRCCS, Istituto Neurologico Carlo Basta, 20133 Milano, Italy
- Correspondence:
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Levy BR, Berger A, Kondziolka D. Diplopia outcomes following stereotactic radiosurgery for petroclival or cavernous sinus meningiomas: patient series. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE225. [PMID: 35733838 PMCID: PMC9210270 DOI: 10.3171/case225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skull base meningiomas (SBM) often present with diplopia due to compression of the abducens cranial nerve (CN VI). The authors evaluated outcomes in 13 patients diagnosed with SBMs who were experiencing diplopia to determine if Gamma Knife surgery (GKS) resulted in resolution of their symptoms. OBSERVATIONS Fourteen patients who were diagnosed with SBMs located in the cavernous sinus, clivus, or petroclival regions and presented with diplopia were treated by GKS. Demographic and clinical data as well as the duration of diplopia prior to GKS were documented. Of the 13 patients included in the study, 1 was excluded because he was lost to follow-up. For the remaining 12, diplopia was resolved in 10 (83%) and no change was noted in 2 (17%). Time to resolution was measured in months, varying from 1 to 30 months, with a median resolution time of 4.5 ± 9.7 months. Of the patients with documented postradiosurgical resolution (n = 10), the median amount of time with diplopia prior to GKS was 1.5 months (range, 1 to 20). LESSONS This study showed that diplopia, related to a basal meningioma, may improve following GKS. An earlier time course to radiosurgery after diplopia onset was associated with better outcomes.
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Affiliation(s)
- Bennett R. Levy
- Department of Neurosurgery, NYU Langone Medical Center, New York, New York
| | - Assaf Berger
- Department of Neurosurgery, NYU Langone Medical Center, New York, New York
| | - Douglas Kondziolka
- Department of Neurosurgery, NYU Langone Medical Center, New York, New York
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Haq IBI, Wahyuhadi J, Suryonurafif A, Arifianto MR, Susilo RI, Nagm A, Goto T, Ohata K. Modified Transpetrosal-Transtentorial Approach for Resection of Large and Giant Petroclival Meningioma: Technical Nuance and Surgical Experiences. J Neurol Surg A Cent Eur Neurosurg 2021; 83:578-587. [PMID: 34794193 DOI: 10.1055/s-0041-1731753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Meningiomas arising from the petroclival area remain a challenge for neurosurgeons. Various approaches have been proposed to achieve maximum resection with minimal morbidity and mortality. Also, some articles correlated preservation of adjacent veins with less neurologic deficits. OBJECTIVE To describe the experiences in using a new technique to achieve maximal resection of petroclival meningiomas and preserving the superior petrosal veins (SPVs) and the superior petrosal sinus (SPS). METHODS A retrospective analysis of 26 patients harboring a true petroclival meningioma with a diameter ≥25 mm and undergoing surgery with the modified transpetrosal-transtentorial approach (MTTA) was performed. RESULTS Fifty-four percent of 22 patients complained of severe headache at presentation. There was also complaint of cranial nerve (CN) deficit, with CN VII deficit being the most common (present in 42% of patients). The average tumor size (measured as maximum diameter) was 45.2 mm, and most of the tumors compressed the brainstem. Total resection was achieved in 12 patients (46.2%), whereas the others were excised subtotally (54.8%). Most of the patients had WHO grade I (96.1%) meningioma; only one had a grade II (3.8%) meningioma. In addition, clinical improvement and persistence of symptoms were observed in 17 (65.4%) and 8 (30.7%) patients, respectively, and postoperative permanent CN injury was observed in 3 (11.5%) patients. CONCLUSION Using the MTTA, maximal resection with preservation of the CNs and neurovascular SPV-SPS complex can be achieved. Therefore, further studies and improvements of the technique are required to increase the total resection rate without neglecting the complications that may develop postoperatively.
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Affiliation(s)
- Irwan Barlian Immadoel Haq
- Department of Neurosurgery, dr. Soetomo Academic General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Joni Wahyuhadi
- Department of Neurosurgery, dr. Soetomo Academic General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Akhmad Suryonurafif
- Department of Neurosurgery, dr. Soetomo Academic General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Reza Arifianto
- Department of Neurosurgery, dr. Soetomo Academic General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Rahadian Indarto Susilo
- Department of Neurosurgery, dr. Soetomo Academic General Hospital, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Alhusain Nagm
- Department of Neurosurgery, Al-Azhar University/Faculty of Medicine Nasr City, Cairo, Egypt
| | - Takeo Goto
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji Ohata
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Li H, Huang H, Zhang X, Wang Y, Ren X, Cui Y, Sui D, Lin S, Jiang Z, Zhang G. Postoperative Long-Term Independence Among the Elderly With Meningiomas: Function Evolution, Determinant Identification, and Prediction Model Development. Front Oncol 2021; 11:639259. [PMID: 33763371 PMCID: PMC7982808 DOI: 10.3389/fonc.2021.639259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Maintenance of postoperative long-term independence has value for older adults who undergo surgical procedures. However, independence has barely caught attention for the elderly with meningiomas. Preventing postoperative long-term independence decline in this population necessitates the identification of the factors related to this outcome and minimizing their implications. Therefore, we assessed the independence evolution and identified potential determinants and population. Materials and Methods From 2010 to 2016, elderly meningioma patients (≥65 years old) undergoing operation at Beijing Tiantan Hospital were included in our study. The primary outcome was 3-year (i.e., long-term) postoperative independence measured by Karnofsky performance scale (KPS) score. We used univariate and multivariate analyses to determine the risk factors for postoperative long-term independence, and nomogram was established. Results A total of 470 patients were included eligibly. The distribution in each KPS was significantly different before and 3 years after resection (P < 0.001). Especially in patients with preoperative KPS 80 and 70, only 17.5 and 17.3% of the patients kept the same KPS after 3 years, and the remaining patients experienced significant polarization. The most common remaining symptom cluster correlated with postoperative long-term independence included fatigue (R = −0.795), memory impairment (R = −0.512), motor dysfunction (R = −0.636) and communication deficits (R = −0.501). Independent risk factors for postoperative long-term non-independence included: advanced age (70–74 vs. 65–69 OR: 2.631; 95% CI: 1.545–4.481 and ≥75 vs. 65–69 OR: 3.833; 95% CI: 1.667–8.812), recurrent meningioma (OR: 7.791; 95% CI: 3.202–18.954), location in the skull base (OR: 2.683; 95% CI: 1.383–5.205), tumor maximal diameter >6 cm (OR: 3.089; 95% CI: 1.471–6.488), nerves involved (OR: 3.144; 95% CI: 1.585–6.235), high risk of WHO grade and biological behavior (OR: 2.294; 95% CI: 1.193–4.408), recurrence during follow-up (OR: 10.296; 95% CI: 3.253–32.585), lower preoperative KPS (OR: 0.964; 95% CI: 0.938–0.991) and decreased KPS on discharge (OR: 0.967; 95% CI: 0.951–0.984) (P < 0.05). The discrimination and calibration of the nomogram revealed good predictive ability (C-index: 0.810). Conclusion Elderly meningioma patients might present significant polarization trend in maintaining long-term independence after surgery. Our findings will be helpful for guiding surgical management for the elderly with meningioma and provide proposals for early functional rehabilitation.
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Affiliation(s)
- Haoyi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huawei Huang
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaokang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yonggang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dali Sui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guobin Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Materi J, Mampre D, Ehresman J, Rincon-Torroella J, Chaichana KL. Predictors of recurrence and high growth rate of residual meningiomas after subtotal resection. J Neurosurg 2021; 134:410-416. [PMID: 31899874 DOI: 10.3171/2019.10.jns192466] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 10/28/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The extent of resection has been shown to improve outcomes in patients with meningiomas. However, resection can be complicated by constraining local anatomy, leading to subtotal resections. An understanding of the natural history of residual tumors is necessary to better guide postsurgical management and minimize recurrence. This study seeks to identify predictors of recurrence and high growth rate following subtotal resection of intracranial meningiomas. METHODS Adult patients who underwent primary surgical resection of a WHO grade I meningioma at a tertiary care institution from 2007-2017 were retrospectively reviewed. Volumetric tumor measurements were made on patients with subtotal resections. Stepwise multivariate proportional hazards regression analyses were performed to identify factors associated with time to recurrence, as well as stepwise multivariate regression analyses to assess for factors associated with high postoperative growth rate. RESULTS Of the 141 patients (18%) who underwent radiographic subtotal resection of an intracranial meningioma during the reviewed period, 74 (52%) suffered a recurrence, in which the median (interquartile range, IQR) time to recurrence was 14 (IQR 6-34) months. Among those tumors subtotally resected, the median pre- and postoperative tumor volumes were 17.19 cm3 (IQR 7.47-38.43 cm3) and 2.31 cm3 (IQR 0.98-5.16 cm3), which corresponded to a percentage resection of 82% (IQR 68%-93%). Postoperatively, the median growth rate was 0.09 cm3/year (IQR 0-1.39 cm3/year). Factors associated with recurrence in multivariate analysis included preoperative tumor volume (hazard ratio [HR] 1.008,95% confidence interval [CI] 1.002-1.013, p = 0.008), falcine location (HR 2.215, 95% CI 1.179-4.161, p = 0.021), tentorial location (HR 2.410, 95% CI 1.203-4.829, p = 0.024), and African American race (HR 1.811, 95% CI 1.042-3.146, p = 0.044). Residual volume (RV) was associated with high absolute annual growth rate (odds ratio [OR] 1.175, 95% CI 1.078-1.280, p < 0.0001), with the maximum RV benefit at < 5 cm3 (OR 4.056, 95% CI 1.675-9.822, p = 0.002). CONCLUSIONS By identifying predictors of recurrence and growth rate, this study helps identify potential patients with a high chance of recurrence following subtotal resection, which are those with large preoperative tumor volume, falcine location, tentorial location, and African American race. Higher RVs were associated with tumors with higher postoperative growth rates. Recurrences typically occurred 14 months after surgery.
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Affiliation(s)
- Joshua Materi
- 1Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland; and
| | - David Mampre
- 1Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland; and
| | - Jeff Ehresman
- 1Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland; and
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Balasa A, Hurghis C, Tamas F, Chinezu R. Surgical Strategies and Clinical Outcome of Large to Giant Sphenoid Wing Meningiomas: A Case Series Study. Brain Sci 2020; 10:brainsci10120957. [PMID: 33317116 PMCID: PMC7764378 DOI: 10.3390/brainsci10120957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022] Open
Abstract
Large to giant sphenoid wing meningiomas (SWMs) remain surgically challenging due to frequent vascular encasement and a tendency for tumoral invasion of the cavernous sinus and optic canal. We aimed to study the quality of resection, postoperative clinical evolution, and recurrence rate of large SWMs. This retrospective study enrolled 21 patients who underwent surgery between January 2014 and December 2019 for SWMs > 5 cm in diameter (average 6.3 cm). Tumor association with cerebral edema, extension into the cavernous sinus or optic canal, degree of encasement of the major intracranial arteries, and tumor resection grade were recorded. Cognitive decline was the most common symptom (65% of patients), followed by visual decline (52%). Infiltration of the cavernous sinus and optical canal were identified in five and six patients, respectively. Varying degrees of arterial encasement were seen. Gross total resection was achieved in 67% of patients. Long-term follow-up revealed improvement in 17 patients (81%), deterioration in two patients (9.5%), and one death (4.7%) directly related to the surgical procedure. Seven patients displayed postoperative tumor progression and two required reintervention 3 years post initial surgery. Tumor size, vascular encasement, and skull base invasion mean that, despite technological advancements, surgical results are dependent on surgical strategy and skill. Appropriate microsurgical techniques can adequately solve arterial encasement but tumor progression remains an issue.
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Affiliation(s)
- Adrian Balasa
- Department of Neurosurgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Tîrgu Mureș, Romania; (A.B.); (C.H.); (F.T.)
- Department of Neurosurgery, Tîrgu Mureș Emergency Clinical County Hospital, 540136 Tîrgu Mureș, Romania
| | - Corina Hurghis
- Department of Neurosurgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Tîrgu Mureș, Romania; (A.B.); (C.H.); (F.T.)
- Department of Neurosurgery, Tîrgu Mureș Emergency Clinical County Hospital, 540136 Tîrgu Mureș, Romania
| | - Flaviu Tamas
- Department of Neurosurgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Tîrgu Mureș, Romania; (A.B.); (C.H.); (F.T.)
- Department of Neurosurgery, Tîrgu Mureș Emergency Clinical County Hospital, 540136 Tîrgu Mureș, Romania
| | - Rares Chinezu
- Department of Neurosurgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Tîrgu Mureș, Romania; (A.B.); (C.H.); (F.T.)
- Department of Neurosurgery, Tîrgu Mureș Emergency Clinical County Hospital, 540136 Tîrgu Mureș, Romania
- Correspondence:
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Bu J, Pan P, Yao H, Gong W, Liu Y, Yu Z, Wang Z, Wu J, Chen G. Small Cerebellopontine Angle Meningioma-Surgical Experience of 162 Patients and Literature Review. Front Oncol 2020; 10:558548. [PMID: 33163399 PMCID: PMC7581792 DOI: 10.3389/fonc.2020.558548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Objective To retrospective analyze the clinical data of 162 patients with small cerebellopontine angle meningiomas. To compare with the nature of tumors, symptoms pre- and post-treatments, neurological deficit, and prognosis in literatures. To explore the surgical outcomes of small cerebellopontine angle meningiomas and summarize the surgical experience. Methods All of 162 patients with small cerebellopontine angle meningiomas underwent surgery between January 2010 and December 2019 in the neurosurgery department of the First Affiliated Hospital of Soochow University. This cohort of eight literatures reported about stereotactic radiotherapy of small cerebellopontine angle meningiomas between January 2010 and December 2019. All clinical data were obtained for analysis. Results Compared with stereotactic radiotherapy, surgical treatment for small cerebellopontine angle meningiomas lead to the better results in relieving symptoms and inhibiting tumor progression. Surgical treatment can obtain the exact pathological examination results to guide the further treatment. Conclusions Surgical treatment should be the first choice for small cerebellopontine angle meningiomas.
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Affiliation(s)
- Jiyuan Bu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Pengjie Pan
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui Yao
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Weiyi Gong
- Department of Neurosurgery, First People's Hospital of Kunshan, Suzhou, China
| | - Yuan Liu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhengquan Yu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiang Wu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Gang Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, China
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Zhang P, Li Y, Zhang J, Zhang H, Wang X, Dong L, Yan Z, She L, Wang X, Wei M, Tang C. Risk factors analysis and a nomogram model establishment for late postoperative seizures in patients with meningioma. J Clin Neurosci 2020; 80:310-317. [DOI: 10.1016/j.jocn.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/02/2020] [Accepted: 06/06/2020] [Indexed: 02/07/2023]
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11
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Pemov A, Dewan R, Hansen NF, Chandrasekharappa SC, Ray-Chaudhury A, Jones K, Luo W, Heiss JD, Mullikin JC, Chittiboina P, Stewart DR, Asthagiri AR. Comparative clinical and genomic analysis of neurofibromatosis type 2-associated cranial and spinal meningiomas. Sci Rep 2020; 10:12563. [PMID: 32724039 PMCID: PMC7387487 DOI: 10.1038/s41598-020-69074-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/19/2020] [Indexed: 12/31/2022] Open
Abstract
Neurofibromatosis type 2 (NF2) is an autosomal dominant Mendelian tumor predisposition disorder caused by germline pathogenic variants in the tumor suppressor NF2. Meningiomas are the second most common neoplasm in NF2, often occurring in multiple intracranial and spinal locations within the same patient. In this prospective longitudinal study, we assessed volumes and growth rates of ten spinal and ten cranial benign meningiomas in seven NF2 patients that concluded with surgical resection and performed whole-exome sequencing and copy-number variant (CNV) analysis of the tumors. Our comparison of the volume and the growth rate of NF2-associated spinal and cranial meningiomas point to the differences in timing of tumor initiation and/or to the differences in tumor progression (e.g., non-linear, saltatory growth) at these two anatomical locations. Genomic investigation of these tumors revealed that somatic inactivation of NF2 is the principal and perhaps the only driver of tumor initiation; and that tumor progression likely occurs via accumulation of CNVs, rather than point mutations. Results of this study contribute to a better understanding of NF2-associated meningiomas clinical behavior and their genetic underpinnings.
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Affiliation(s)
- Alexander Pemov
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA
| | - Ramita Dewan
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA.,Neuromuscular Disease Research Section, National Institute On Aging, NIH, Bethesda, MD, USA
| | - Nancy F Hansen
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA
| | - Settara C Chandrasekharappa
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA
| | - Abhik Ray-Chaudhury
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Kristine Jones
- Frederick National Laboratory for Cancer Research, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wen Luo
- Frederick National Laboratory for Cancer Research, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - John D Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - James C Mullikin
- Cancer Genetics and Comparative Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA.,NIH Intramural Sequencing Center, National Human Genome Research Institute, NIH, Rockville, MD, USA
| | - Prashant Chittiboina
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Douglas R Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
| | - Ashok R Asthagiri
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA. .,Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
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Four Independent Predictors of Postoperative Seizures After Meningioma Surgery: A Meta-Analysis. World Neurosurg 2019; 130:537-545.e3. [DOI: 10.1016/j.wneu.2019.06.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 12/29/2022]
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