Current knowledge on spinal meningiomas: a systematic review protocol

Abstract

IntroductionMeningiomas are primary central nervous system tumours that arise from both cranial and spinal meninges. Spinal meningiomas occur less frequently than their cranial counterparts and are consequently given less attention in the literature. Therefore, systematic studies are needed to summarise the current knowledge on spinal meningiomas, providing a solid evidence base for treatment strategies. This systematic review of the literature will therefore assess studies describing spinal meningiomas, their epidemiology, diagnostics, treatment and outcomes.Methods and analysisElectronic databases, including PubMed, Web of Science and Embase, will be searched using the keywords “spinal” and “meningioma”. The search will be set to provide only English studies published after 2000 to avoid any conflicts regarding terminology and classification, as well as to reflect the current status. Case reports, editorials, letters and reviews will also be excluded. Reference lists of relevant records will also be searched. Identified studies will be screened for inclusion, by one reviewer in a first step and then three in the next step to decrease the risk of bias. The results will be categorised to allow for a structured summary of the outcomes and their evidence grade conforming to the Grading of Recommendations, Assessment, Development and Evaluation approach. Categories may include: epidemiology, histopathology, radiological diagnostics, surgery, complications, non-surgical or adjuvant treatments, disease outcomes and predictors, and lastly recurrence. This review will summarise the current knowledge on spinal meningiomas to allow for a better understanding of the disease and contribute to improve its management. For clinicians, the systematic collection and grading of available evidence may aid in decision making and for those seeking to further the scientific field, this review may help to identify areas where knowledge is currently lacking.Ethics and disseminationEthics approval was not required for our systematic review as it is based on existing publications. The results will be disseminated via submission for publication in a peer-reviewed journal.

Current Knowledge on Spinal Meningiomas Epidemiology, Tumor Characteristics and Non-Surgical Treatment Options: A Systematic Review and Pooled Analysis (Part 1)

“…The review protocol was registered within the International Prospective Register of Systematic Reviews (PROSPERO) (Registration ID: CRD42022330809 and Date of registration: 17 May 2022). The record was consistently updated in the event of any major change to the design of the work and the study protocol has previously been published [ 19 ].…”

“…The review also intends to identify knowledge gaps to guide future research efforts. This review will follow the outlines proposed in a previously published protocol [ 19 ].…”

Unsuccessful external validation of the MAC-score for predicting increased MIB-1 index in patients with spinal meningiomas

“…Poor preoperative status, longer time to surgery and reoperation are all predictors of unfavorable outcome. ( 2 , 4 ) Similarly, known risk factors for tumor recurrence may for example include higher WHO grade and higher Simpson grade resection. ( 2 , 45 , 46 ) Hence, in our opinion, large multicentric datasets are needed to yield enough power for scores to directly predict outcomes of clinical interest (unfavorable neurologic status or recurrence) relying on well documented and logical predictors.…”

“…Even though most spinal meningiomas are benign (World Health Organization (WHO) grade 1), ( 2 ) they can cause spinal cord compression and neurological deficits. ( 3 ) Surgery is the treatment of choice for symptomatic patients, ( 2 ) and often associated with improved neurological function.…”

“…Even though most spinal meningiomas are benign (World Health Organization (WHO) grade 1), ( 2 ) they can cause spinal cord compression and neurological deficits. ( 3 ) Surgery is the treatment of choice for symptomatic patients, ( 2 ) and often associated with improved neurological function. ( 4 ) The functional status in these patients is usually assessed using standardized methods, such as the modified McCormick scale (mMCS) ( Table 1 ).…”