Prognostic factors and role of adjuvant therapies in the management of parasagittal meningiomas

Details

Serval ID
serval:BIB_974A15F7601C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prognostic factors and role of adjuvant therapies in the management of parasagittal meningiomas
Journal
Journal of Radiosurgery and SBRT
Author(s)
Villard J., Robert T., Pica A., Mirimanoff R.O., Levivier M., Bloch J.
ISSN
2156-4639
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
1
Number
4
Pages
287-294
Language
english
Notes
pdf type: Clinical Investigation
Abstract
Background: The goal of the present study was to retrospectively analyze our series of parasagittal meningiomas, treated by either single or combined therapies (surgery and/or SRS and FSRT), in order to determine the factors that influence patient outcome.
Methods: Between January 1999 and May 2007, 37 parasagittal meningiomas were treated in our center. We compared the outcome of the parasagittal meningiomas in relation to the treatment and adjuvant treatment given, their location along the SSS, their volume, their histological and resection grade as well as the patient's sex and age to understand which factors influenced their natural history.
Findings: Median follow-up was 6.7 years (2.4-12 years). Tumor grades and Simpson resection grade were distributed evenly along the SSS. The actuarial overall tumor control rate was 65.9%. Regression analysis showed, that the tumor histological grade and the Simpson resection grade were two significant factors in determining the tumor control (p<0.002 and p<0.008). Location along the SSS showed a lower control rate in the posterior third (p<0.002). Sex, age and tumor volume, however, were not significant factors. Moreover, and unexpectedly, the In our series, the proportion of adjuvant treatment was much higher than in former described series (39% vs 7%) but with similar control rate and lower morbidity and mortality.
Conclusions: In our series, histological grade and Simpson grade are independent factors for recurrence and tumor control. Interestingly, location in the posterior third of the SSS seems to be another independent factor for recurrence. In order to avoid major morbidities related to surgery we advocate earlier use of adjuvant therapies for higher histological grade tumors and for tumors located at the posterior portion of the SSS, but definitive conclusions might warrant a larger series.
Keywords
Parasagittal meningiomas, neurosurgery, stereotactic radiosurgery, brain radiotherapy, tumor control, prognosic factors
Create date
12/02/2014 11:54
Last modification date
20/08/2019 14:59
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