Recurrence of benign spinal neoplasms

Abstract

The outcome of surgical treatment of benign spinal neoplasms is considered to be excellent, with good improvement of neurological function. The risk of recurrence is estimated to be very low, except with subtotal resections. This retrospective study was designed to establish the course of illness, clinical outcome, and recurrence rate of benign spinal tumours. We present an overview of the clinical outcome and surgical treatment of 197 benign spinal tumours carried out in our centre from 1980 to 1999. Clinical history, signs, surgical approach, outcome, and radiological reports were obtained by reviewing patient charts. The most frequent benign tumour was meningeoma (41%), closely followed by neurinoma (33%) and neurofibroma (6.1%). Of all tumours, 79.7% were completely resected. Recurrence happened in 10.2% on an average of 4.3 years postoperatively. Only 2 patients suffered from neurofibromatosis. All neurinomas were completely resected at first operation, whereas three out of seven recurrent meningeomas and all ependymomas were classified as subtotally resected. Seventy per cent were treated by repeated surgical intervention. Benign tumours usually can be completely removed without adding to patients' neurological deficits. Benign tumours recur in 10.2% of cases, thus requiring long-term follow-up. Magnetic resonance imaging (MRI) studies are recommended up to 5 years postoperatively as a routine procedure.

Outcome predictors and complications in the management of intradural spinal tumours

“…Whilst benign tumours require long-term follow-up with MRI and further resection for recurrence, some of our patients with successfully excised meningiomas are discharged but given open access to the neurosurgical clinic if they deteriorate. The meningioma recurrence was 5.5% in our study with a mean time to recurrence of 3 years and 1 month, which is comparable to other published studies [25]. Unsurprisingly, the majority of complications were due to dural CSF leak and meningitis, the incidence of which ranges from 5-13% and 1-10%, respectively [5,8,9,21,23].…”

Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales

“…Magnetic resonance imaging is recommended up to 5 years postoperatively as a routine procedure. 75 In some patients with benign spinal intradural tumors, subtotal resection is acceptable. For example, the probability of tumor recurrence or progression is lower in cases involving meningiomas of the spine than for other sites.…”

The Cytogenetic Relationship between Primary and Recurrent Meningiomas Points to the Need for New Treatment Strategies in Cases at High Risk of Relapse

“…Because of this and the fact that recurrent meningiomas usually show identical histopathologic characteristics to those observed at diagnosis, the question remains about whether tumor recurrence, even many years after surgery, could be due to regrowth of the tumor, emergence of another meningioma, or both. In fact, among other additional prognostic factors, the extent of the surgical resection has been considered as an obvious prognostic factor because tumors that undergo a wider excision will be less likely to recur (6,7,12,15,16). In turn, the effectiveness of tumor resection could also be related to its localization (3, 6 -8, 15, 17) although this still remains controversial (2,18).…”