A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma

Miao, Yi; Lu, Xiao‐Jie; Qiu, Yongming; Jiang, Jiyao; Lin, Yongcheng

doi:10.1016/j.jocn.2009.07.111

Cited by 52 publications

(46 citation statements)

References 23 publications

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“…To support the transition back to ordinary life, the involvement of significant others would probably be advantageous. Furthermore, our findings support the suggestions of Miao et al. (2010) that persons who have undergone meningioma surgery might benefit from psychological support.…”

Section: Nursing Implicationssupporting

confidence: 88%

Living in a paradox – women’s experiences of body and life‐world after meningioma surgery

Wenström

Ebbeskog

2011

Journal of Advanced Nursing

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wenström i., eriksson l.e. & ebbeskog b. (2012) Living in a paradox – women’s experiences of body and life‐world after meningioma surgery. Journal of Advanced Nursing68(3), 559–568. Abstract Aims. The aims of the study were to describe how persons who have undergone benign meningioma surgery experience their body and life‐world and to illuminate the meaning of the illness, operation and recovery. Background. Meningioma, which is often benign, is the most commonly diagnosed brain tumour. Studies have shown that persons with meningioma tend to be more psychologically affected than persons with other brain tumours. To our knowledge, no previous studies have focused on the life‐world or body experience of these persons. Method. Narrative interviews with seven women conducted over a 6‐month period (2008–2009) were analyzed using a phenomenological hermeneutical method. Findings. Four themes were identified: In between double threats: the tumour and operation: the participants seemed to perceive a paradox in the sense that the tumour was both benign and threatening and the surgery both curing and risky; the wound as an open gate: the wound is visibly healed, but perceived as unhealed; the suffering body overflows life: the participants were prevented from regaining their body, feeling fragile and oversensitive to impressions; and the need to be embraced by attention: taking the participants’ needs seriously facilitated understanding of the diagnosis. Conclusion. The participants in this study described emotional distress when recovering from meningioma surgery. It is essential for nurses to be aware of the various meanings people ascribe to events that disrupt their lives and the transition process in connection with meningioma treatment.

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Section: Nursing Implicationssupporting

confidence: 88%

Living in a paradox – women’s experiences of body and life‐world after meningioma surgery

Wenström

Ebbeskog

2011

Journal of Advanced Nursing

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“…Early reports often classified atypical meningiomas together with malignant or anaplastic meningiomas, 2,26,31 which have been shown to have significantly worse OS and PFS. 17,49 Greater extent of resection was correlated with decreased recurrence rates in these initial series, 15,49 with a 5-year survival of up to 87% in small series.…”

mentioning

confidence: 99%

The role of radiotherapy following gross-total resection of atypical meningiomas

Komotar

Iorgulescu

Raper

et al. 2012

JNS

150

103

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Object Atypical (WHO Grade II) meningiomas comprise a heterogeneous group of tumors, with histopathology delineated under the guidance of the WHO and a spectrum of clinical outcomes. The role of postoperative radiotherapy for patients with atypical meningiomas who have undergone gross-total resection (GTR) remains unclear. In this paper, the authors sought to clarify this role by reviewing their experience over the past 2 decades. Methods The authors retrospectively analyzed all patients at their institution who underwent GTR between 1992 and 2011 with a final histology demonstrating atypical meningioma. Information regarding patients, tumor characteristics, and postoperative adjuvant therapy was gleaned from medical records. Time to recurrence and overall survival were analyzed using univariate, multivariate, and Kaplan-Meier survival analyses. Results Forty-five patients who met the inclusion criteria underwent GTR for atypical meningiomas. By a median follow-up of 44.1 months, 22% of atypical meningiomas had recurred. There was no recurrence in 12 (92%) of 13 patients who received postoperative radiotherapy or in 19 (59%) of 32 patients who did not undergo postoperative radiotherapy (p = 0.085), demonstrating a strong trend toward improved local control with postoperative radiotherapy. No other factors were significantly associated with recurrence in univariate or multivariate analyses. Conclusions This retrospective series supports the observation that postoperative radiotherapy likely results in lower recurrence rates of gross totally resected atypical meningiomas. Although a multicenter prospective trial will ultimately be needed to fully define the role of radiotherapy in managing gross totally resected atypical meningiomas, the authors' results contribute to a growing number of series that support routine postoperative radiotherapy as an adjuvant treatment for these lesions.

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“…To our knowledge, only 1 detailed case report exists documenting time‐dependent recovery of motor and cognitive functions in a boy aged 6 years who had a right frontal lobe atypical meningioma . The paucity of data regarding these outcome measures is in contrast to adult meningioma survivors, in which several studies have demonstrated that significant numbers of patients experience impaired cognition and worse health‐related quality of life compared with healthy matched controls . Because child and adolescent meningioma is rare, the number of patients available for study is small, which may explain the lack of statistical significance for several variables associated with morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Meningioma is the most frequently occurring CNS tumor in adults, 56 and several studies have reported an increased risk of morbidity in survivors. [57][58][59][60][61] In contrast, child and adolescent meningioma is rare, with the majority of reports for this condition retrospective in nature and restricted to single cases and case series. Consequently, there is a paucity of literature regarding long-term outcomes in survivors.…”

Section: Discussionmentioning

confidence: 99%

“…71 The paucity of data regarding these outcome measures is in contrast to adult meningioma survivors, in which several studies have demonstrated that significant numbers of patients experience impaired cognition and worse health-related quality of life compared with healthy matched controls. [58][59][60][61] Because child and adolescent meningioma is rare, the number of patients available for study is small, which may explain the lack of statistical significance for several variables associated with morbidity. The small number of patients who suffered morbidity as a consequence of therapy precluded meaningful statistical analysis for therapy as a risk factor.…”

Section: Discussionmentioning

confidence: 99%

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Morbidity in survivors of child and adolescent meningioma

Kotecha

Jacoby

Cole

et al. 2013

Cancer

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BackgroundThe extent of initial surgical resection has been identified as the strongest prognostic indicator for survival in child and adolescent meningioma. Given the paucity of data concerning long-term outcome, the authors undertook a meta-analysis to analyze morbidity in survivors of this disease.MethodsIndividual patient data were obtained from 19 case series published over the last 23 years through direct communication with the authors. Ordinal logistic regression models were used to assess the influence of risk factors on morbidity.ResultsOf 261 patients, 48% reported a completely normal life with no morbidity, and 25% had moderate/severe meningioma-associated morbidity at last follow-up. Multivariate analysis identified relapse as the only independent variable associated with an increased risk of morbidity (odds ratio, 4.02; 95% confidence interval, 2.11-7.65; P ≤ .001). Univariate analysis also revealed an increased risk for patients with neurofibromatosis (odds ratio, 1.90; 95% confidence interval, 1.04-3.48; P = .04). Subgroup analysis identified a higher incidence of morbidity among patients who had intracranial tumors with a skull base location compared with a nonskull base location (P ≤ .001). Timing at which morbidity occurred was available for 70 patients, with persistence of preoperative tumor-related symptoms in 67% and as a result of therapy in 20%.ConclusionsThe majority of survivors of child and adolescent meningioma had no or only mild long-term morbidity, whereas 25% had moderate/severe morbidity, with a significantly increased risk in patients with relapsed disease. In the majority, morbidity occurred as a consequence of the tumor itself, justifying aggressive surgery to achieve gross total resection. However, for patients with neurofibromatosis and skull base meningioma, a more cautious surgical approach should be reserved.

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A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma

Cited by 52 publications

References 23 publications

Living in a paradox – women’s experiences of body and life‐world after meningioma surgery

Living in a paradox – women’s experiences of body and life‐world after meningioma surgery

The role of radiotherapy following gross-total resection of atypical meningiomas

Morbidity in survivors of child and adolescent meningioma

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