• Antonio Nogueira de Almeida, Pereira Benedito Jamilson Araújo BJA Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil., Paulo Henrique Pires Aguiar, Wellingson Silva Paiva, Hector Navarro Cabrera, Clemar Corrêa da Silva, Manoel Jacobsen Teixeira, and Marie Suely Kazue Nagahashi SKN Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil..
• Departamento de Neurologia, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil; Divisão de Neurocirurgia Funcional IPQ, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil. Electronic address: almeida@hc.fm.usp.br.
• World Neurosurg. 2017 Jun 1; 102: 139-143.

ObjectiveThe medical literature still lacks information about the impact of surgery and adjuvant treatment on the life of patients with meningioma. The clinical outcome, timing of tumor recurrence, and causes of death are often overlooked. This study evaluates these data taking into account tumor localization and histologic grade.MethodsThe article is a cross-sectional study of patients operated on between 2000 and 2014 in a single institution. The series has 593 adult patients (442 females and 151 males) and follow-up of 68.8 ± 48.9 months. Imaging of 434 patients was reviewed and 379 patients/families interviewed.ResultsSixty-eight deaths were related to tumor treatment/progression and 36 to other causes. After 2 years of surgery, deaths not related to tumor were 7 times more frequent than were tumor-related deaths (odds ratio, 7.1; 95% confidence interval, 2.8-19.5; P < 0.0001). Ten-year survival was expected in 85% of patients with grade I (GI) meningioma, 35% of patients with atypic (GII) meningioma, and 0% of patients with anaplastic (GIII) meningioma. Convexity tumors had about half the risk of recurrence compared with other localizations (odds ratio, 0.4; 95% confidence interval, 0.27-0.67; P = 0.0002). In GI meningioma, recurrence was neither related to death nor to impairment of independent life. All patients with GII and GIII meningioma who had recurrence died. 96.3% of interviewees reported neurologic improvement or stability after the surgery.ConclusionsHistologic grade is the most important factor for long-term survival. Complete resection has to be pursued in GII and GIII meningioma but must be carefully weighed against morbidities in GI meningioma.Copyright © 2017 Elsevier Inc. All rights reserved.

25 keywords...

hide…