Benign meningiomas: Primary treatment selection affects survival

Condra, Kellie S.; Buatti, John M.; Mendenhall, William M.; Friedman, William A.; Marcus, Robert B.; Rhoton, Albert L.

doi:10.1016/s0360-3016(97)00317-9

Cited by 312 publications

(143 citation statements)

References 40 publications

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“…18,26,27 Some authors include adjuvant radiation therapy in their treatment regimen for atypical and malignant meningiomas, 29 although this practice remains controversial. 1,9,16,18,22,32,36 Pollock et al 34 demonstrated equipoise in recurrence rates after radiosurgery as the primary management strategy and after Simpson Grade I resection for benign meningiomas smaller than 3.5 cm, and superiority of adjuvant radiotherapy when compared with Grade II-IV resections. On the other hand, for tumors that are large (> 3 cm), those with symptomatic mass effect, or those causing partial venous occlusion, radiosurgery may not be appropriate as the primary treatment.…”

Section: Conservative Managementmentioning

confidence: 99%

Management of meningiomas involving the transverse or sigmoid sinus

Mazur¹,

Cutler²,

Couldwell³

et al. 2013

FOC

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Meningiomas that invade the transverse or sigmoid sinuses are uncommon tumors that are challenging to treat surgically. Although the risk of recurrence is associated with the extent of resection, complete removal of meningiomas in these locations must be balanced with avoidance of venous outflow obstruction, which could cause venous infarction and significant neurological consequences. When a meningioma occludes a venous sinus completely, gross-total resection of the intravascular portion is commonly performed. When the tumor invades but does not completely obliterate a major venous sinus, however, opinions differ on whether to accept a subtotal resection or to open the sinus, perform a complete resection, and reconstruct the venous outflow tract. In this paper, the authors review the different strategies used to treat these lesions and provide illustrative case examples.

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Section: Conservative Managementmentioning

confidence: 99%

Management of meningiomas involving the transverse or sigmoid sinus

Mazur¹,

Cutler²,

Couldwell³

et al. 2013

FOC

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“…Benin memengiomalarda gross total rezeksiyon tek başına küratifdir. [9,[11][12][13] Yalnızca subtotal rezeksiyon sonrası ise 10 yıllık progresyon oranları %55-63 arasındadır. [13,14] Radyoterapi lokal kontrolü artırır.…”

Section: Discussionunclassified

Stereotactic radiotherapy results of menengiomas with a CyberKnife: a single center experience

Isik¹

2014

TJ Oncol

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“…The concept of tumor debulking in symptomatic patients (who are then simply monitored to determine if the residual tumor enlarges) is more commonly practiced with parasagittal meningiomas, but for convexity tumors, a complete resection of the mass is the usual goal. Condra and colleagues 3 found a 70% rate of tumor progression after subtotal resection without fractionated radiation therapy. Recurrence rates are clearly elevated with atypical or malignant meningiomas, 18,19 and survival > 10 years for patients with malignant meningiomas is rare.…”

Section: Indications For Radiosurgerymentioning

confidence: 98%

Stereotactic radiosurgery for convexity meningiomas

Kondziolka

Madhok²,

Lunsford³

et al. 2009

JNS

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Object Meningiomas of the cerebral convexity are often surgically curable because both the mass and involved dura mater can be removed. Stereotactic radiosurgery has become an important primary or adjuvant treatment for patients with intracranial meningiomas. The authors evaluated clinical and imaging outcomes in patients with convexity meningiomas after radiosurgery. Methods The patient cohort consisted of 125 patients with convexity meningiomas managed using radiosurgery at some point during an 18-year period. The patient series included 76 women, 55 patients who had undergone prior resection, and 6 patients with neurofibromatosis Type 2. Tumors were located in frontal (80 patients), parietal (24 patients), temporal (12 patients), and occipital (9 patients) areas. The WHO tumor grades in patients with prior resections were Grade I in 34 patients, Grade II in 15 patients, and Grade III in 6 patients. Seventy patients underwent primary radiosurgery and therefore had no prior histological tumor diagnosis. The mean tumor volume was 7.6 ml. Radiosurgery was performed using the Leksell Gamma Knife with a mean tumor margin dose of 14.2 Gy. Results Serial imaging was evaluated in 115 patients (92%). After primary radiosurgery, the tumor control rate was 92%. After adjuvant radiosurgery, the control rate was 97% for Grade I tumors. The actuarial tumor control rates at 3 and 5 years for the entire series were 86.1 ± 3.8% and 71.6 ± 8.6%, respectively. For patients with benign tumors (Grade I) and those without prior surgery, the actuarial tumor control rate was 95.3 ± 2.3% and 85.8 ± 9.3%, respectively. Delayed resection after radiosurgery was performed in 9 patients (7%) at an average of 35 months. No patient developed a subsequent radiation-induced tumor. The overall morbidity rate was 9.6%. Symptomatic peritumoral imaging changes compatible with edema or adverse radiation effects developed in 5%, at a mean of 8 months. Conclusions Stereotactic radiosurgery provides satisfactory control rates either after resection or as an alternate to resection, particularly for histologically benign meningiomas. Its role is most valuable for patients whose tumors affect critical neurological regions and who are poor candidates for resection. Both temporary and permanent morbidity are related to brain location and tumor volume.

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Benign meningiomas: Primary treatment selection affects survival

Cited by 312 publications

References 40 publications

Management of meningiomas involving the transverse or sigmoid sinus

Management of meningiomas involving the transverse or sigmoid sinus

Stereotactic radiotherapy results of menengiomas with a CyberKnife: a single center experience

Stereotactic radiosurgery for convexity meningiomas

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