Simple Tumor Localization Scale for Estimating Management Outcome of Intracranial Meningioma

Intracranial meningiomas are typically benign extracerebral tumors derived from dural arachnoid cells. Predominantly, these tumors are effectively managed surgically, but the prognosis is heavily dependent on a tumor's histologic heterogeneity and its location. It is known that reproductive and hormonal factors increase the risk for meningioma in adult females, but their prognostic value still remains controversial. This study's aim was to examine possible correlation between tumor location and outcome, as well as to evaluate the prognostic value of the proposed simple tumor localization scale in predicting the management outcome of intracranial meningioma.

In a retrospective, cross-section survey, a single-institution cohort of 243 patients operated on due to intracranial meningioma was analyzed. The investigated parameters were age and gender, tumor location, and extent of surgery (Simpson grading). The patients were divided into 2 groups allocating tumors to central and peripheral position within the cranial vault. The outcome was estimated by Karnofsky Performance Score (KPS) at discharge from hospital and Glasgow Outcome Scale at 1 year after surgery.

A statistically significant correlation between tumor location and outcome, as well as negative correlation between age and outcome, were observed (P < 0.001).

When estimating the management outcome of intracranial meningiomas, we propose a simple localization scale dividing the tumors into central and peripheral positions. Central tumor location might be prognostically unfavorable due to involvement of major neurovascular structures. Among the independent factors predicting favorable tumor response to surgery, more effective outcomes associated with peripheral tumor location and younger age were observed.