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McDaniel AK, Carlson B, Dunn IF, Nipp R. The experience of caregiving for adults with benign brain tumors: An integrative review. Neurooncol Pract 2024; 11:240-248. [PMID: 38737614 PMCID: PMC11085835 DOI: 10.1093/nop/npae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Caregiving for the adult benign brain tumor (aBBT) population is unique, as patients' extended period of survivorship poses significant challenges related to the long-term sequelae of the disease and the foreboding possibility of recurrence. In this integrative review, we examined the caregiving experience across the spectrum of the aBBT population. Methods We searched OVID, CINAHL, and PubMed databases from 2000 to 2022. We included studies primarily focused on caregivers of aBBT and written in English. Results Among 594 papers identified in the initial review, we included a final list of 7 papers. Among these 7 papers, 5 central themes emerged. First, we identified a theme surrounding psychosocial and emotional needs, which included the social isolation of caregiving. The second theme related to informational care needs, including what is considered to be the normal course of recovery after surgery. The third theme focused on access to services, including specialist neurosurgical care, and the fourth theme related to financial strain and the economic burdens associated with long-term follow-up. Lastly, we found a theme surrounding family role changes, which included the shift from spouse to caregiver. Conclusions In this review, we identified themes highlighting similarities to the high-grade glioma population. However, we uncovered distinct differences in terms of caregiver characteristics, length of survivorship, and the burden of caregiving over time. Collectively, our findings underscore the incomplete understanding of the caregiving experience across the spectrum of the aBBT population.
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Affiliation(s)
- Amanda Kate McDaniel
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
- Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
| | - Barbara Carlson
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
- College of Health and Human Services, School of Nursing, University of North Carolina, Wilmington, North Carolina, USA
| | - Ian F Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
| | - Ryan Nipp
- Department of Medicine, Section of Oncology at the Stephenson Cancer Center, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
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Koch L, Tichy A, Gradner G. Outcome and quality of life after intracranial meningioma surgery in cats. J Feline Med Surg 2023; 25:1098612X231194425. [PMID: 37870933 PMCID: PMC10812019 DOI: 10.1177/1098612x231194425] [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] [Indexed: 10/25/2023]
Abstract
OBJECTIVES The present study aimed to evaluate the postoperative quality of life (QOL) after surgery for the treatment of intracranial meningioma in cats. METHODS The study included 14 cases that underwent craniotomy from May 2009 to March 2021. Owners were contacted via telephone after a median time of 967 (range 227-4209) days after surgery and surveyed with a specially designed questionnaire that consisted of three domains, subdivided into different items. Physical behaviour, including general condition, food intake, mobility and overall impression, was evaluated from 0, reflecting the worst status, to 10, reflecting the best. The development of preoperative existing clinical signs, seizures and concurrent medication were evaluated individually for each patient. The time span necessary for the improvement of each item was recorded. Finally, satisfaction about the decision for surgery was ranked from 0 to 10. RESULTS Thirteen questionnaires were completed. Three cats were evaluated twice owing to revision surgery. Owners reported a statistically significant (P <0.001) improvement from immediately after the operation to 240 days after surgery. Preoperative clinical signs resolved in 95% of cases. All questioned owners would opt for surgery again. CONCLUSIONS AND RELEVANCE QOL after surgery for intracranial meningioma in cats seems encouraging regarding our study. Nevertheless, limitations, such as small sample size, recall bias, lack of a control group and validation of the questionnaire, need to be kept in mind when interpreting the results.
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Affiliation(s)
- Lydia Koch
- Department for Small Animals and Horses, Small Animal Surgery, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Alexander Tichy
- Bioinformatics and Biostatistics Platform, Department of Biomedical Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Gabriele Gradner
- Department for Small Animals and Horses, Small Animal Surgery, University of Veterinary Medicine Vienna, Vienna, Austria
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Pettersson-Segerlind J, Fletcher-Sandersjöö A, von Vogelsang AC, Persson O, Kihlström Burenstam Linder L, Förander P, Mathiesen T, Edström E, Elmi-Terander A. Long-Term Follow-Up, Treatment Strategies, Functional Outcome, and Health-Related Quality of Life after Surgery for WHO Grade 2 and 3 Intracranial Meningiomas. Cancers (Basel) 2022; 14:cancers14205038. [PMID: 36291821 PMCID: PMC9600120 DOI: 10.3390/cancers14205038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/03/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Meningiomas are the most common group of primary intracranial tumors. While the majority are classified as WHO grade 1, WHO grade 2 and 3 meningiomas have poorer outcomes, even after gross total resection, and often require supplementary treatment. Long-term follow-up data regarding the progression-free survival (PFS) and overall survival (OS) for grade 2 and 3 tumors are scarce, and data evaluating the routine use of supplementary radiotherapy and radiosurgery have been inconclusive. Furthermore, few studies have reported data on the health-related quality of life (HRQoL), anxiety, and depression for these patients. In this population-based cohort study, we reviewed 51 cases of WHO grade 2 and 3 meningiomas. We found that the median OS was 13 years for grade 2 and 1.4 years for grade 3 meningiomas. Meningioma was the cause of death in 93% of the patients who passed away. The surviving patients showed HRQoL measures comparable to that of the general population, with the exception of significantly more anxiety and depression. All patients who worked preoperatively returned to work after their treatment. Abstract Progression-free survival (PFS) and overall survival (OS) for WHO grade 2 and 3 intracranial meningiomas are poorly described, and long-term results and data evaluating the routine use of supplementary fractionated radiotherapy (RT) or stereotactic radiosurgery (SRS) has been inconclusive. The aim of this study was to determine the long-term PFS and OS at a center that does not employ routine adjuvant RT. For this purpose, a retrospective population-based cohort study was conducted of all WHO grade 2 and 3 meningiomas surgically treated between 2005 and 2013. The cohort was uniformly defined according to the WHO 2007 criteria to allow comparisons to previously published reports. Patient records were reviewed, and patients were then prospectively contacted for structured quality-of-life assessments. In total, 51 consecutive patients were included, of whom 43 were WHO grade 2 and 8 were grade 3. A Simpson grade 1–2 resection was achieved in 62%. The median PFS was 31 months for grade 2 tumors, and 3.4 months for grade 3. The median OS was 13 years for grade 2, and 1.4 years for grade 3. The MIB-1-index was significantly associated with an increased risk for recurrence (p = 0.018, OR 1.12). The median PFS was significantly shorter for high-risk tumors compared to the low-risk group (10 vs. 46 months; p = 0.018). The surviving meningioma patients showed HRQoL measures comparable to that of the general population, with the exception of significantly more anxiety and depression. All patients who worked before surgery returned to work after their treatment. In conclusion, we confirm dismal prognoses in patients with grade 2 and 3 meningiomas, with tumor-related deaths resulting in severely reduced OS. However, the cohort was heterogenous, and a large subgroup of both grade 2 and 3 meningiomas was alive at 10 years follow-up, suggesting that a cure is possible. In addition, fractionated radiotherapy and chemotherapy had little benefit when introduced for recurrent and progressive diseases.
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Affiliation(s)
- Jenny Pettersson-Segerlind
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Alexander Fletcher-Sandersjöö
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Ann-Christin von Vogelsang
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Oscar Persson
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Lars Kihlström Burenstam Linder
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Petter Förander
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Tiit Mathiesen
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Neurosurgery, Rigshospitalet, Institute of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Erik Edström
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Adrian Elmi-Terander
- Department of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Correspondence:
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Schiavolin S, Mariniello A, Broggi M, Abete-Fornara G, Bollani A, G GP, Bottini G, Querzola M, Scarpa P, Casarotti A, De Michele S, Isella V, Mauri I, Maietti A, Miramonti V, Orru MI, Pertichetti M, Pini E, Regazzoni R, Subacchi S, Ferroli P, Leonardi M. Patient-reported outcome and cognitive measures to be used in vascular and brain tumor surgery: proposal for a minimum set. Neurol Sci 2022; 43:5143-5151. [DOI: 10.1007/s10072-022-06162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
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Sekely A, Zakzanis KK, Mabbott D, Tsang DS, Kongkham P, Zadeh G, Edelstein K. Long-term neurocognitive, psychological, and return to work outcomes in meningioma patients. Support Care Cancer 2022; 30:3893-3902. [PMID: 35041087 DOI: 10.1007/s00520-022-06838-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study aimed to investigate long-term neurocognitive, psychological, and return to work (RTW) outcomes in meningioma patients, and to explore whether neurocognitive and psychological factors influence RTW outcomes in this population. METHODS In this retrospective study, 61 meningioma patients completed in-depth clinical neuropsychological assessments. Of these participants, 42 were of working-age and had RTW information available following neuropsychological assessment. Seventy-one percent and 80% of patients received radiation and surgery, respectively, with 49% receiving both radiation and surgery. Associations between demographic, medical, neurocognitive, psychological, and RTW data were analyzed using multivariable logistic regression analyses. RESULTS In our sample, 68% of patients exhibited global neurocognitive impairment, with the largest effect sizes found on tests of visual memory (d = 0.73), executive function (d = 0.61), and attention (d = 0.54). Twenty-seven percent exhibited moderate to severe levels of depressive symptoms. In addition, 23% and 30% exhibited clinically significant state and trait anxiety, respectively. Forty-eight percent of patients were unable to RTW. Younger age, faster visuomotor processing speed, and, unexpectedly, higher trait anxiety scores were associated with an increased likelihood of returning to work. CONCLUSIONS Meningioma patients are at risk of experiencing neurocognitive deficits, psychological symptoms, and difficulties returning to work. Our results suggest that neurocognitive and psychological factors contribute to RTW status in meningioma patients. Prospective research studies are necessary to increase our understanding of the complexity of functional disability in this growing population.
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Affiliation(s)
- Angela Sekely
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada. .,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Donald Mabbott
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Psychology, Neurosciences, and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Derek S Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.,Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Paul Kongkham
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, ON, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, ON, Canada
| | - Kim Edelstein
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Corniola MV, Roche PH, Bruneau M, Cavallo LM, Daniel RT, Messerer M, Froelich S, Gardner PA, Gentili F, Kawase T, Paraskevopoulos D, Régis J, Schroeder HW, Schwartz TH, Sindou M, Cornelius JF, Tatagiba M, Meling TR. Management of cavernous sinus meningiomas: Consensus statement on behalf of the EANS skull base section. BRAIN AND SPINE 2022; 2:100864. [PMID: 36248124 PMCID: PMC9560706 DOI: 10.1016/j.bas.2022.100864] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/08/2022] [Accepted: 01/16/2022] [Indexed: 01/04/2023]
Abstract
Introduction The evolution of cavernous sinus meningiomas (CSMs) might be unpredictable and the efficacy of their treatments is challenging due to their indolent evolution, variations and fluctuations of symptoms, heterogeneity of classifications and lack of randomized controlled trials. Here, a dedicated task force provides a consensus statement on the overall management of CSMs. Research question To determine the best overall management of CSMs, depending on their clinical presentation, size, and evolution as well as patient characteristics. Material and methods Using the PRISMA 2020 guidelines, we included literature from January 2000 to December 2020. A total of 400 abstracts and 77 titles were kept for full-paper screening. Results The task force formulated 8 recommendations (Level C evidence). CSMs should be managed by a highly specialized multidisciplinary team. The initial evaluation of patients includes clinical, ophthalmological, endocrinological and radiological assessment. Treatment of CSM should involve experienced skull-base neurosurgeons or neuro-radiosurgeons, radiation oncologists, radiologists, ophthalmologists, and endocrinologists. Discussion and conclusion Radiosurgery is preferred as first-line treatment in small, enclosed, pauci-symptomatic lesions/in elderly patients, while large CSMs not amenable to resection or WHO grade II-III are candidates for radiotherapy. Microsurgery is an option in aggressive/rapidly progressing lesions in young patients presenting with oculomotor/visual/endocrinological impairment. Whenever surgery is offered, open cranial approaches are the current standard. There is limited experience reported about endoscopic endonasal approach for CSMs and the main indication is decompression of the cavernous sinus to improve symptoms. Whenever surgery is indicated, the current trend is to offer decompression followed by radiosurgery. A thorough evaluation of cavernous sinus meningiomas by a multidisciplinary team is mandatory. Microsurgery should be considered for aggressive lesions in young patients. Extended endoscopic approaches can be effective when combined with radiotherapy. Stereotaxic radiotherapy and stereotaxic radiosurgery offer excellent tumour control in small/asymptomatic lesions .
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Preusser M, Silvani A, Le Rhun E, Soffietti R, Lombardi G, Sepulveda JM, Brandal P, Brazil L, Bonneville-Levard A, Lorgis V, Vauleon E, Bromberg J, Erridge S, Cameron A, Lefranc F, Clement PM, Dumont S, Sanson M, Bronnimann C, Balaná C, Thon N, Lewis J, Mair MJ, Sievers P, Furtner J, Pichler J, Bruna J, Ducray F, Reijneveld JC, Mawrin C, Bendszus M, Marosi C, Golfinopoulos V, Coens C, Gorlia T, Weller M, Sahm F, Wick W. Trabectedin for recurrent WHO grade 2 or 3 meningioma: a randomized phase 2 study of the EORTC Brain Tumor Group (EORTC-1320-BTG). Neuro Oncol 2021; 24:755-767. [PMID: 34672349 DOI: 10.1093/neuonc/noab243] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND No systemic treatment has been established for meningioma progressing after local therapies. METHODS This randomized, multicenter, open-label, phase 2 study included adult patients with recurrent WHO grade 2 or 3 meningioma. Patients were 2:1 randomly assigned to intravenous trabectedin (1.5 mg/m 2 every three weeks) or local standard of care (LOC). The primary endpoint was progression-free survival (PFS). Secondary endpoints comprised overall survival (OS), objective radiological response, safety, quality of life (QoL) assessment using the QLQ-C30 and QLQ-BN20 questionnaires, and we performed tissue-based exploratory molecular analyses. RESULTS Ninety patients were randomized (n=29 in LOC, n=61 in trabectedin arm). With 71 events, median PFS was 4.17 months in the LOC and 2.43 months in the trabectedin arm (hazard ratio [HR]=1.42; 80% CI, 1.00-2.03; p=0.294) with a PFS-6 rate of 29.1% (95% CI, 11.9%-48.8%) and 21.1% (95% CI, 11.3%-32.9%), respectively. Median OS was 10.61 months in the LOC and 11.37 months in the trabectedin arm (HR=0.98; 95% CI, 0.54-1.76; p=0.94). Grade ≥3 adverse events occurred in 44.4% patients in the LOC and 59% of patients in the trabectedin arm. Enrolled patients had impeded global QoL and overall functionality and high fatigue before initiation of systemic therapy. DNA methylation class, performance status, presence of a relevant co-morbidity, steroid use, and right hemisphere involvement at baseline were independently associated with OS. CONCLUSIONS Trabectedin did not improve PFS and OS and was associated with higher toxicity than LOC treatment in patients with non-benign meningioma. Tumour DNA methylation class is an independent prognostic factor for OS.
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Affiliation(s)
- Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Antonio Silvani
- Department of Neuro-oncology, IRCCS Fondazione Istituto Neurologico Carlo Besta, Via Giovanni Celoria 11, 20133 Milan, Italy
| | - Emilie Le Rhun
- University of Lille, U-1192, F-59000 Lille, France; Inserm, U-1192, F-59000 Lille, France; CHU Lille, General and Stereotaxic Neurosurgery service, F-59000 Lille, France; Oscar Lambret Center, Medical Oncology Department, F-59000 Lille
| | - Riccardo Soffietti
- Dept. Neuro-Oncology, University and City of Health and Science Hospital, Via Cherasco 15, 10126 Turin, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV- IRCCS, Via Gattamelata 64, 35128 Padua, Italy
| | - Juan Manuel Sepulveda
- Neurooncology Unit, Hospital Universitario 12 de Octubre, Av. de Córdoba s/n, 28041 Madrid, Spain
| | - Petter Brandal
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, P.O.Box 4950 Nydalen, 0424 Oslo, Norway
| | - Lucy Brazil
- St Thomas' Hospital, Westminster Bridge Rd, London SE1 7EH, United Kingdom
| | | | - Veronique Lorgis
- Department of Medical Oncology, Centre Georges François Leclerc, 1 Rue du Professeur Marion, 21000 Dijon, France
| | - Elodie Vauleon
- Department of Medical Oncology, Centre Eugene Marquis, Avenue de la Bataille Flandres Dunkerque, 25042 Rennes, France
| | - Jacoline Bromberg
- Department of Neuro-Oncology, Erasmus MC University Medical Center Cancer Center, Doctor Molewaterplein 40, 3015 Rotterdam, The Netherlands
| | - Sara Erridge
- Edinburgh Cancer Centre, Western General Hospital, Crewe Rd S, Edinburgh EH4 2XU, United Kingdom
| | - Alison Cameron
- Bristol Cancer Institute, University Hospitals Bristol, Marlborough St, Bristol BS1 3NU, United Kingdom
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Erasme; Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Paul M Clement
- Department of Oncology, KU Leuven and Department of General Medical Oncology, UZ Leuven, Leuven Cancer Institute, Herestraat 49, 3000 Leuven, Belgium
| | - Sarah Dumont
- Institut Gustave-Roussy, Université Paris-Saclay, Medical Oncology Department, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Marc Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, 47-83 Boulevard del l'Hôpital, 75013, Paris, France
| | - Charlotte Bronnimann
- Department of Medical Oncology, Bordeaux University Hospital-CHU, Bordeaux, France, University of Bordeaux, Place Amélie Raba Léon, 33000 Bordeaux, France
| | - Carmen Balaná
- Department of Medical Oncology, Catalan Institute of Oncology, Carretera Canyet sn, 08916 Badalona , Barcelona, Spain
| | - Niklas Thon
- Department of Neurosurgery, Faculty of Medicine and University Hospital, University of Munich LMU), Marchioninistraße 15, 81377 Munich, Germany
| | - Joanne Lewis
- Freeman Hospital, Freeman Rd, High Heaton, Newcastle NE7 7DN, United Kingdom
| | - Maximilian J Mair
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany, Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research DKTK), German Cancer Research Center DKFZ), Im Neuenheimer Feld 224, 69120 Heidelberg, Germany
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Josef Pichler
- Department of Internal Medicine and Neurooncology, Neuromed Campus, Kepler University Hospital, Johannes Kepler University of Linz, Wagner-Jauregg-Weg 15, 4020 Linz, Austria
| | - Jordi Bruna
- Unit of Neuro-Oncology, Hospital Universitari de Bellvitge-Institut Català D'Oncologia L'Hospitalet, Avinguda de la Granvia de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francois Ducray
- Unit of Neuro-Oncology, Hospices Civils de Lyon and Department of Cancer Cell Plasticity, Cancer Research Center of Lyon, Claude Bernard University, 28 Rue Laennec, 69008 Lyon, France
| | - Jaap C Reijneveld
- Brain Tumor Center, Cancer Center Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, Netherlands and Stichting Epilepsie Instellingen Nederland, Achterweg 3, 2103 SW Heemstede, Netherlands
| | - Christian Mawrin
- Department of Neuropathology, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vassilis Golfinopoulos
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Corneel Coens
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Thierry Gorlia
- European Organisation for Research and Treatment of Cancer EORTCHeadquarter, Avenue E. Mounier 83/11, 1200 Brussels, Belgium
| | - Michael Weller
- Department of Neurology, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany, Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research DKTK), German Cancer Research Center DKFZ), Im Neuenheimer Feld 224, 69120 Heidelberg, Germany
| | - Wolfgang Wick
- Neurology Clinic, Heidelberg University Medical Center, Clinical Cooperation Unit, Neurooncology, German Cancer Research Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Maggio I, Franceschi E, Tosoni A, Nunno VD, Gatto L, Lodi R, Brandes AA. Meningioma: not always a benign tumor. A review of advances in the treatment of meningiomas. CNS Oncol 2021; 10:CNS72. [PMID: 34015955 PMCID: PMC8162186 DOI: 10.2217/cns-2021-0003] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/30/2021] [Indexed: 11/21/2022] Open
Abstract
Meningiomas are the most common primary intracranial tumors. The majority of meningiomas are benign, but they can present different grades of dedifferentiation from grade I to grade III (anaplastic/malignant) that are associated with different outcomes. Radiological surveillance is a valid option for low-grade asymptomatic meningiomas. In other cases, the treatment is usually surgical, aimed at achieving a complete resection. The use of adjuvant radiotherapy is the gold standard for grade III, is debated for grade II and is not generally indicated for radically resected grade I meningiomas. The use of systemic treatments is not standardized. Here we report a review of the literature on the clinical, radiological and molecular characteristics of meningiomas, available treatment strategies and ongoing clinical trials.
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Affiliation(s)
- Ilaria Maggio
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
| | - Enrico Franceschi
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
| | - Alicia Tosoni
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
| | - Vincenzo Di Nunno
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
| | - Lidia Gatto
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
| | - Raffaele Lodi
- IRCSS Istituto di Scienze Neurologiche di Bologna, Bologna 40139, Italy
| | - Alba A Brandes
- Medical Oncology Department, Azienda USL, Via Altura 3, 40139, Bologna, Italy
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Constanthin PE, Gondar R, Fellrath J, Wyttenbach IM, Tizi K, Weman L, Vayssière P, Schaller K, Meling TR. Neuropsychological Outcomes after Surgery for Olfactory Groove Meningiomas. Cancers (Basel) 2021; 13:2520. [PMID: 34063924 PMCID: PMC8196649 DOI: 10.3390/cancers13112520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In recent years, several studies have reported abnormal pre- and postoperative neuropsychological functioning in patients with meningiomas located in the prefrontal cortex (notably the ventromedial region). In the case of olfactory groove meningiomas, the tumor is in direct contact with the inferior aspect of the prefrontal cortex, a cortical region with crucial roles in decision-making, cognition and memory functions, potentially negatively impacting neuropsychological functions. MATERIALS AND METHODS We retrospectively compared pre- and post-operative neuropsychological testing of 17 patients undergoing surgical removal of olfactory groove meningiomas in our institution between January 2013 and December 2018. Neuropsychological results were obtained from the patients' medical history and normalized as z-scores of their respective cognitive functions. RESULTS Assessment of cognitive follow-up showed an important heterogeneity among patients. Pre-operative cognitive impairment was observed in most patients, particularly in cognitive flexibility (mean z-score: -1.35). Immediate post-operative cognitive status showed an overall impairment in all domains of cognition, significant for the domains of attention (p = 0.0273) and flexibility (p = 0.0234) and almost significant for the domain of language (p = 0.0547). The late follow-up at one year showed a trend towards general improvement, although attention and flexibility remained impaired. DISCUSSION Olfactory groove meningiomas impact pre-frontal cortex cognitive functions, particularly in the domain of cognitive flexibility. After an initial postoperative worsening, patients tended to improve in most aspects after one year, aside from cognitive flexibility and attention.
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Affiliation(s)
- Paul E. Constanthin
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
| | - Renato Gondar
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
| | - Julia Fellrath
- Neuropsychology Unit, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland; (J.F.); (I.M.W.)
| | - Isaline Mottet Wyttenbach
- Neuropsychology Unit, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland; (J.F.); (I.M.W.)
| | - Karima Tizi
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
| | - Leo Weman
- Faculty of Medicine, University of Lausanne, 1011 Lausanne, Switzerland;
| | - Pia Vayssière
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
| | - Karl Schaller
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
| | - Torstein R. Meling
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, 1205 Geneva, Switzerland; (P.E.C.); (R.G.); (K.T.); (P.V.); (K.S.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland
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