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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(08): 705-715
DOI: 10.1590/0004-282X-ANP-2020-0441
Article

Epidemiological features of meningiomas: a single Brazilian center’s experience with 993 cases

Características epidemiológicas de meningiomas: experiência de um centro único brasileiro com 993 casos
Benedicto Oscar Colli 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
Hélio Rubens Machado 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
Carlos Gilberto Carlotti  Jr
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
João Alberto Assirati  Jr
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
Ricardo Santos De Oliveira 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
Guilherme Gozzoli Podolsky Gondim 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Cirurgia, Divisão de Neurocirurgia, Ribeirão Preto SP, Brazil.
,
Antonio Carlos Dos Santos 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Imagem Médica, Hematologia e Oncologia Clínica, Ribeirão Preto SP, Brazil.
,
Luciano Neder 
3   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Patologia, Ribeirão Preto SP, Brazil.
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ABSTRACT

Background: Meningiomas are the most frequent primary central nervous system (CNS) tumors. Their geographical and ethnic characteristics need to be known, in order to enable rational treatment. Objective: To investigate clinical and epidemiological aspects in a series of patients with meningiomas. Methods: Retrospective analysis on the demographic profile, location and histopathology of 993 patients with meningiomas (768 operated and 225 not operated). Results: Meningiomas represented 43.8% of the primary CNS tumors; 6.8% were multiple tumors (14.7% with neurofibromatosis 2) and 0.6% were radiation-induced tumors. The mean ages were 53.0 and 63.9 years for operated and non-operated patients and the female/male ratios were 3.2:1 and 6.3:1. Diagnosis was made later among females. The peak incidences were in the 6th and 7th decades respectively for operated and non-operated patients. The incidence was low at early ages and higher among patients aged 70+ years. The meningiomas were intracranial in 96.5% and most were WHO grade I (88.9%) and transitional. In the spinal canal (3.5%), they occurred mainly in the dorsal region (all grade I; mostly transitional). The racial distribution was 1.0% in Asian-Brazilians, 87% in Caucasians and 12% in African-Brazilians. 83.4% and 51.6% of the patients were estimated to be recurrence-free at 10 and 20 years, and the mortality rate was 3%. Conclusions: Most of the demographic data were similar to what has been observed in other western centers. Differences were higher incidence of meningiomas, female and older predominance in non-operated patients, predominance in Caucasian, and higher association with neurofibromatosis 2.

RESUMO

Antecedentes: Meningiomas são os tumores mais frequentes do sistema nervoso central (SNC). Suas características étnicas e geográficas precisam ser conhecidas para o seu tratamento racional. Objetivo: Investigar aspectos clínicos e epidemiológicos de uma série de pacientes com meningiomas. Métodos: Análise retrospectiva demográfica de 993 pacientes com meningiomas (768 operados e 225 tratados conservadoramente) Resultados: Meningiomas constituíram 43.8% dos tumores primários do SNC. 0.8% deles eram múltiplos (14,7% com neurofibromatose 2) e 0,6% eram radioinduzidos. A idade média e o índice mulheres/homens foram respectivamente 53,0 e 63,9 anos e 3.2:1 e 6.3:1 para pacientes operados e não operados. O diagnóstico foi mais tardio em mulheres. Ocorreram picos de incidências na 6ª e na 7ª décadas respectivamente para pacientes operados e não operados. A incidência foi menor na infância e maior após 70 anos. Meningiomas predominaram no crânio (96.5%), a maioria grau I da OMS, subtipo transicional. Do total, 3.5% ocorreram no canal raquídeo, principalmente na região torácica, todos grau I, a maioria transicional. Em relação à distribuição racial, 1.0% dos meningiomas ocorreu em amarelos, 87% em brancos e 12% em negros. As taxas de sobrevida sem recorrência foram 83.4% e 51.6% em 10 e 20 anos e a mortalidade operatória foi 3%. Conclusões: A maioria dos dados demográficos observados foi similar aos de outros centros ocidentais. As diferenças observadas foram maior incidência, predominância em mulheres e idosos nos pacientes não operados e em caucasianos, e maior associação com neurofibromatose 2.

Keywords:

Meningioma - Demographic Data - Pathology - General Surgery - Risk Factors - Neoplasm Recurrence, Local

Palavras-chave:

Meningioma - Dados Demográficos - Patologia - Cirurgia Geral - Fatores de Risco - Recidiva Local de Neoplasia

Authors’ contributions:

BOC: conceptualization, investigation, data curation, writing; HRM, CGCJ, JAAJ: conceptualization, investigation (supporting); RSO, GGPG: data curation, investigation, writing original raft, writing-review (supporting); ACS, LN: investigation, validation (supporting).




Publication History

Received: 21 September 2020

Accepted: 04 November 2020

Article published online:
01 June 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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