Impaired survival and long-term neurological problems in benign meningioma

Alkemade, Hanna van; Leau, Michelle de; Dieleman, Edith; Kardaun, J. W. P. F.; Os, Rob van; Vandertop, W. Peter; Furth, Wouter R. van; Stalpers, Lukas J.A.

doi:10.1093/neuonc/nos013

Cited by 204 publications

(146 citation statements)

References 44 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…For benign meningiomas, some authors reported that Simpson Grade I-III resection yielded equivalent results, 31,58,74 while others have advocated for Simpson Grade I or even more radical resection. 28,42,79 This issue becomes even more ambiguous for AMs. Hammouche et al reported a 5-year PFS of 74% after Simpson Grade I resection of AMs but only 34% after Simpson Grade II resection.…”

Section: Surgical Managementmentioning

confidence: 99%

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

116

View full text Add to dashboard Cite

The management of WHO Grade II “atypical” meningiomas (AMs) and Grade III “malignant” meningiomas (MMs) remains controversial and under-investigated in prospective studies. The roles of surgery, radiation therapy, radiosurgery, and chemotherapy have been incompletely delineated. This has left physicians to decipher how they should treat patients on a case-by-case basis. In this study, the authors review the English-language literature on the management and clinical outcomes associated with AMs and MMs diagnosed using the WHO 2000/2007 grading criteria. Twenty-two studies for AMs and 7 studies for MMs were examined in detail. The authors examined clinical decision points using the literature and concepts from evidence-based medicine. Acknowledging the retrospective nature of the studies concerning AM and MM, the authors did find evidence for the following clinical strategies: 1) maximal safe resection of AM and MM; 2) active surveillance after gross-total resection of AM; 3) adjuvant radiation therapy after subtotal resection of AM, especially in the absence of putative radioresistant features; and 4) adjuvant radiation therapy after resection of MM.

show abstract

Section: Surgical Managementmentioning

confidence: 99%

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Sun¹,

Hawasli²,

Huang

et al. 2015

FOC

116

View full text Add to dashboard Cite

show abstract

“…However, the absence of an arachnoid plane as well as the presence of adhesion between tumor and adjacent brain increases the risk of the surgery 2, 3. Meningioma–brain adhesion typically causes difficult dissection from involved structures including the cortex, vascular structures, and cranial nerves, substantially increasing the risk of stroke or damage to the adjacent brain that may result in permanent neurologic deficits 4. Therefore, the ability to preoperatively determine the presence of a surgically safe plane of dissection would benefit surgical planning, allowing neurosurgeons to more accurately counsel patients on potential surgical complications, length of surgery, and the likelihood of total tumor resection.…”

mentioning

confidence: 99%

Slip interface imaging based on MR‐elastography preoperatively predicts meningioma–brain adhesion

Yin

Hughes

Glaser

et al. 2017

Magnetic Resonance Imaging

View full text Add to dashboard Cite

PurposeTo investigate the ability of slip interface imaging (SII), a recently developed magnetic resonance elastography (MRE)‐based technique, to predict the degree of meningioma–brain adhesion, using findings at surgery as the reference standard.Materials and MethodsWith Institutional Review Board approval and written informed consent, 25 patients with meningiomas >2.5 cm in maximal diameter underwent preoperative SII assessment. Intracranial shear motions were introduced using a soft, pillow‐like head driver and the resulting displacement field was acquired with an MRE pulse sequence on 3T MR scanners. The displacement data were analyzed to determine tumor–brain adhesion by assessing intensities on shear line images and raw as well as normalized octahedral shear strain (OSS) values along the interface. The SII findings of shear line images, OSS, and normalized OSS were independently and blindly correlated with surgical findings of tumor adhesion by using the Cohen's κ coefficient and chi‐squared test.ResultsNeurosurgeons categorized the surgical plane as extrapial (no adhesion) in 15 patients, mixed in four, and subpial (adhesion) in six. Both shear line images and OSS agreed with the surgical findings in 18 (72%) cases (fair agreement, κ = 0.37, 95% confidence interval [CI]: 0.05–0.69), while normalized OSS was concordant with the surgical findings in 23 (92%) cases (good agreement, κ = 0.86, 95% CI: 0.67–1). The correlation between SII predictions (shear line images, OSS, and normalized OSS) and the surgical findings were statistically significant (chi‐squared test, P = 0.02, P = 0.02, and P < 0.0001, respectively).ConclusionSII preoperatively evaluates the degree of meningioma–brain adhesion noninvasively, allowing for improved prediction of surgical risk and tumor resectability. Level of Evidence: 1 Technical Efficacy: Stage 1J. Magn. Reson. Imaging 2017;46:1007–1016.

show abstract

“…The symptoms of meningioma depend on the pressure of the tumor on the brain or spinal cord and the intracranial location of the tumor (3). Symptoms, such as seizures, single or multiple muscle twitches, spasms, loss of control of body functions, change in sensation and partial or total loss of consciousness, are associated with the different locations of the mass (1,4). Meningiomas accounted for ~33.8% of all the primary brain and central nervous system tumors reported in the United States between 2002 and 2006 (2).…”

Section: Introductionmentioning

confidence: 99%

Temporal bone meningioma involving the middle ear: A case report

et al. 2015

View full text Add to dashboard Cite

Abstract. Meningioma is a common intracranial tumor involving the meninges. The localization of this type of tumor is rarely extracranial due to its typically low invasive properties. Furthermore, invasion of the middle ear is exceptional. The present study reported a case of meningioma extending into the middle ear from the middle cranial fossa through the tegmen tympani. The clinical and pathological characteristics, as well as the outcome of the patient, were described. IntroductionMeningioma is a common intracranial tumour, accounting for 13-19% of all primary brain tumors (1). This tumor is generally encapsulated and benign (2). The symptoms of meningioma depend on the pressure of the tumor on the brain or spinal cord and the intracranial location of the tumor (3). Symptoms, such as seizures, single or multiple muscle twitches, spasms, loss of control of body functions, change in sensation and partial or total loss of consciousness, are associated with the different locations of the mass (1,4). Meningiomas accounted for ~33.8% of all the primary brain and central nervous system tumors reported in the United States between 2002 and 2006 (2). Furthermore, in recent decades, increased exposure to risk factors has determined an increase in the incidence of primary brain tumors, inclusive of meningioma, in several countries (5). The predominant risk factor identified is the exposure to ionizing radiation; however, other risk factors may be associated with the risk of meningioma, including elevated estrogen and/or progesterone hormone levels (2,6,7), head trauma (2), cell phone use (2,8), breast cancer (2), occupation (2), diet (2). Notably, a significant inverse correlation has been identified between meningioma and allergies (2,9); Linos et al (10) revealed that individuals with a history of allergy exhibited a lower risk of developing brain tumours than individuals with no history of allergy. Meningiomas have a higher incidence rate among female individuals, with a female to male ratio of ~2:1 (5). In addition, age-specific incidence rates indicate that risk increases with age. Prevalence rates for non-Hispanic individuals of African descent are marginally higher (6.67 per 100,000 persons) compared with Caucasian non-Hispanic and Hispanic individuals (5.90 and 5.94 per 100,000 persons, respectively) (2,4). The primary treatment strategy for meningiomas is total resection surgery if the tumor is benign and in an area of the brain where it can be safely and completely removed. Subsequently, radiation therapy is applied for the most malignant cases of meningioma or when surgery is not feasible due to the meningioma location.Extracranial meningiomas are uncommon (accounting for <2% of meningiomas) (11), particularly those extending into the middle ear. The present study described a rare case of meningioma extending into the middle ear from the middle cranial fossa through the tegmen tympani. Written informed consent was obtained from the patient. Case reportIn May 2004, a 56-year-old woman presented to the Ear Nos...

show abstract

Impaired survival and long-term neurological problems in benign meningioma

Abstract: Long-term survival in WHO grade I meningioma is challenged in patients more than 45 years of age. Excess mortality seems to be associated with both tumor recurrence and stroke. The majority of patients have long-term neurological problems.

Cited by 204 publications

References 44 publications

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas

Slip interface imaging based on MR‐elastography preoperatively predicts meningioma–brain adhesion

Temporal bone meningioma involving the middle ear: A case report

Contact Info

Product

Resources

About