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Multiple meningiomas: does quantity matter? a population-based survival analysis with underlined age and sex
Andres Ramos-Fresnedo1, Ricardo A Domingo1, Tito Vivas-Buitrago1
1Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Introduction:
Intracranial meningiomas rarely present with multiple lesions. To the best of our knowledge, current literature regarding meningiomatosis (MM) is mostly comprised of small case series and individual reports. Hence, survival outcome data are limited. The Objective of this study is to explore the influence of sex, age, and number of lesions on overall survival (OS) in patients with MM.
Methods:
We obtained demographic and clinical data from the surveillance, epidemiology, and end results program (SEER) on adult patients diagnosed with meningiomas from 1975 to 2017. Univariable and multivariable analyses were conducted to assess whether number of lesions, age, and sex had a significant influence on OS.
Results:
99,918 cases were included. Results showed that MM patients had a significantly decreased OS when compared to patients with a single lesion (median OS of 94 and 180 months, respectively; p < 0.001). Further analysis showed a progressive decrease on OS for every additional lesion; 2 (HR 1.659 [CI 95% 1.612-1.708], p < 0.001), 3 (HR 1.877 [CI 95% 1.773-1.988], p < 0.001), and ≥ 4 (HR 2.116 [CI 95% 1.886-2.373], p < 0.001). When assessing for sex differences, female patients had increased OS (HR 0.778 [CI 95% 0.743-0.815], p < 0.001) and decreased risk of developing MM (HR 0.809 [CI 95% 0.784-0.835], p < 0.001).
Conclusion:
Increasing number of meningiomas has a significant negative impact on OS, with a progressive decrease on survival for every additional lesion. Furthermore, female patients had increased OS and decreased risk to develop MM.
Insights
The number of intracranial meningiomas significantly impacts overall survival, with more lesions leading to worse outcomes. Female patients experience increased survival and a lower risk of developing meningiomatosis (MM).
Area of Science:
- Neurosurgery
- Oncology
- Epidemiology
Background:
- Meningiomatosis (MM), characterized by multiple intracranial meningiomas, is rare and poorly understood.
- Existing literature on MM primarily consists of limited case series and individual reports, hindering survival outcome analysis.
Observation:
- This study analyzed data from 99,918 patients diagnosed with meningiomas between 1975 and 2017 using the SEER database.
- The analysis focused on the impact of lesion number, patient age, and sex on overall survival (OS).
Findings:
- Meningiomatosis patients exhibited significantly decreased overall survival compared to those with a single lesion (94 vs. 180 months).
- A progressive decrease in OS was observed with an increasing number of lesions (2, 3, or ≥4 lesions).
- Female patients demonstrated improved OS (HR 0.778) and a reduced risk of developing MM (HR 0.809).
Implications:
- The number of meningiomas is a critical prognostic factor, with each additional lesion negatively affecting survival.
- Female sex is associated with better outcomes and a lower incidence of meningiomatosis.
- These findings highlight the importance of considering lesion burden and sex in managing patients with meningiomatosis.
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