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J Neurol Surg B Skull Base 2012; 73 - A017
DOI: 10.1055/s-0032-1312065

Long-Term Clinical and Surgical Outcomes of Patients with Intracranial Meningiomas

Winward Choy 1(presenter), Won Kim 1, Ashley Osborne 1, Marko Spasic 1, Nicole Cremer 1, Isaac Yang 1
  • 1Los Angeles, USA

Introduction: Meningiomas are the second most common primary CNS neoplasm and are commonly benign and slow growing. While gross total resection has been associated with improved survival, complete surgical resection can be difficult given poor tumor accessibility and proximity to sensitive structures. We review our institution's long-term experience with meningiomas to compare outcomes and complications associated with gross (GTR) and subtotal resection (STR).

Methods: We reviewed all patients with meningiomas treated at Ronald Reagan UCLA Medical Center from 1996 to 2009. Inclusion criteria included (1) histopathologically confirmed primary intracranial meningioma, (2) GTR or STR performed at UCLA, and (3) follow-up ≥2 years. Surgical and clinical outcomes of GTR vs. STR were analyzed.

Results: Of 203 patients receiving surgical resection, 106 met our inclusion criteria. There were 41 males and 65 females, and the average age was 54 years at presentation. There were 84 WHO grade I (79%), 19 WHO grade II (18%), and 3 WHO grade III (3%) meningiomas. Average follow-up was 61.2 months (range: 24 to 172 months). Of the 72 patients undergoing GTR, 5 (7%) received radiotherapy. Of the 34 patients with STR, 19 (56%) received radiotherapy. Overall survival for both groups was 100%. Compared with STR, GTR was associated with improved 3-yr PFS (92.5% vs. 75%, P = 0.062) and 5-yr PFS (92.5% vs. 62.5%, P = 0.002). However, GTR was correlated with increased complications (11% vs. 2.9%, P = 0.26). This difference was not statistically significant. Reported complications included hematoma (2), surgical site infections (2), CSF leak (2), venous infracts (2), and venous thrombosis (1).

Conclusion: Overall, meningiomas are slow growing tumors with a good prognosis, and surgical resection can offer excellent rates of tumor control. Although GTR is associated with longer PFS and should be the goal when feasible, these findings suggest that a more aggressive surgical approach is correlated with increased risk for surgical complications.