Matched case–control analysis of outcomes following surgical resection of incidental meningioma

Chotai, Silky; Tang, Alan R.; Gupta, Rishabh; Guidry, Bradley S.; McDermott, Jake R.; Grisham, Candace J.; Morone, Peter J.; Thompson, Reid C.; Chambless, Lola B.

doi:10.1007/s11060-022-04167-5

Cited by 2 publications

(1 citation statement)

References 43 publications

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“… 31 Further, a recent matched case–control study found that there was no difference in functional or clinical outcomes between patients operated on for symptomatic versus incidental meningiomas. 32 Although early surgery for incidental meningiomas can be indicated for patients with suspected higher histopathological grade (i.e. peritumoral edema, or invasive and rapid growth), or in patients where an attractive treatment window for stereotactic radiotherapy (e.g.…”

Section: Discussionmentioning

confidence: 99%

Growth dynamics of untreated meningiomas

Strand,

Wågø,

Pedersen

et al. 2023

Neuro-Oncology Advances

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Background Knowledge about meningioma growth characteristics is needed for developing biologically rational follow-up routines. In this study of untreated meningiomas followed with repeated MRIs, we studied growth dynamics and explored potential factors associated with tumor growth. Methods In a single-center cohort study, we included 235 adult patients with a radiologically suspected intracranial meningioma and at least three MRI scans during follow-up. Tumors were segmented using an automatic algorithm from contrast enhanced T1-series, and if needed manually corrected. Potential meningioma growth curves were statistically compared; linear, exponential, linear radial, or Gompertzian. Factors associated with growth were explored. Results In 235 patients, 1394 MRI scans were carried out in the median five-year observational period. Of the models tested, a Gompertzian growth curve best described growth dynamics of meningiomas on group level. 59 % of the tumors grew, 27 % remained stable, and 14 % shrunk. Only 13 patients (5 %) underwent surgery during the observational period and were excluded after surgery. Tumor size at time of diagnosis, multifocality, and length of follow-up were associated with tumor growth, whereas age, sex, presence of peritumoral edema or hyperintense T2-signal were not significant factors. Conclusion Untreated meningiomas follow a Gompertzian growth curve, indicating that increasing and potentially doubling of subsequent follow-up intervals between MRIs seems biologically reasonable, instead of fixed time intervals. Tumor size at diagnosis is the strongest predictor of future growth, indicating a potential for longer follow up intervals for smaller tumors. Although most untreated meningiomas grow, few require surgery.

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Section: Discussionmentioning

confidence: 99%