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Skull base meningiomas: neurological outcome after microsurgical resection
Judith Scheitzach1, Karl-Michael Schebesch, Alexander Brawanski
1Department of Neurosurgery, University of Regensburg Medical Center, Franz Josef Strauß Allee 11, 93053, Regensburg, Germany.
Journal of Neuro-Oncology
|November 22, 2013
Summary
Microsurgical resection of skull base meningiomas improves neurological function for most patients. Extent of resection (EOR) impacts outcomes, and factors like tumor size and location predict recurrence risk.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Skull base meningiomas are typically treated with microsurgical resection.
- Maximal tumor resection is linked to better tumor control but carries risks of surgical morbidity.
Purpose of the Study:
- To analyze the relationship between the extent of resection (EOR) and functional outcomes in skull base meningioma patients.
- To identify anatomical and biological factors predicting tumor recurrence and overall patient outcomes.
Main Methods:
- Retrospective analysis of 226 skull base meningioma patients.
- Extent of resection (EOR) assessed using the Simpson scale.
- Neurological function evaluated using the Karnofsky performance score (KPS) and Medical Research Council Neurological Severity Score (MRC-NPS).
Main Results:
- Complete resection was achieved in 62.8% of patients, correlating with tumor location.
- Morbidity and mortality rates were 32.1% and 2.7%, respectively; 3.5% developed new permanent deficits.
- 60.1% of patients with preoperative deficits showed improvement; KPS and MRC-NPS scores improved significantly post-surgery.
- Recurrence rate was 15.5%. Independent predictors for recurrence included tumor size, bone/venous sinus infiltration, WHO grade, and poor EOR.
Conclusions:
- Microsurgical resection of skull base meningiomas leads to neurological improvement in most patients.
- Tumor location influences the degree of functional improvement.
- Identifying specific risk factors for recurrence is crucial for guiding postoperative management and improving long-term patient outcomes.
