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Prognostic Factors and Treatment Strategies for Elderly Patients with Malignant Meningioma: A SEER Population-Based
Songshan Feng1,2,3,4, Jing Li5, Fan Fan1
1Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Objective:
Malignant meningioma (MM) is a relatively rare disease with poor survival. Few studies had focused on MM in the elderly population. This study aims to explore the prognostic factors and optimal therapeutic strategy in elderly patients with MM.
Methods:
We took advantage of the Surveillance, Epidemiology, and End Results (SEER) database to include 275 adult patients with histologically confirmed MM between 2011 and 2018. The Kaplan-Meier curves were plotted by different covariates to reveal the survival probability. Univariate and multivariable Cox proportional hazard regression analyses were applied to identify prognostic factors for cancer-specific survival (CSS).
Results:
The multivariable analysis in the elderly group revealed that when compared with patients receiving gross total resection (GTR), patients receiving biopsy had significantly worse CSS (HR = 3.72; 95% CI: 1.35-10.21; P = 0.011), whereas patients receiving subtotal resection (STR) had nearly the same CSS (HR = 0.83; 95% CI: 0.37-1.86; P = 0.653). Meanwhile, postoperative radiotherapy (PORT) showed no significant association with CSS in the elderly patient group (HR = 0.94; 95% CI: 0.42-2.12; P = 0.888).
Conclusion:
Surgical resection is recommended for elderly patients with MM in the absence of surgical contraindications, but GTR does not present survival benefit in the elderly patients compared with STR. Additional large-scale clinical studies are needed to explore the survival benefit of PORT applied in patients with MM.
Insights
For elderly patients with malignant meningioma (MM), surgical resection is advised, but gross total resection (GTR) offers no survival advantage over subtotal resection (STR). Postoperative radiotherapy (PORT) did not significantly impact survival in this age group.
Area of Science:
- Neuro-oncology
- Geriatric Medicine
- Surgical Oncology
Background:
- Malignant meningioma (MM) is rare with poor prognosis.
- Limited research exists on MM in elderly populations.
- Optimal treatment strategies for elderly MM patients are unclear.
Purpose of the Study:
- To identify prognostic factors in elderly MM patients.
- To determine the optimal therapeutic strategy for elderly MM patients.
Main Methods:
- Utilized the SEER database (2011-2018) for 275 adult MM patients.
- Kaplan-Meier curves analyzed survival probabilities.
- Cox regression identified prognostic factors for cancer-specific survival (CSS).
Main Results:
- Biopsy correlated with significantly worse CSS compared to gross total resection (GTR) (HR=3.72).
- Subtotal resection (STR) showed similar CSS to GTR (HR=0.83).
- Postoperative radiotherapy (PORT) had no significant association with CSS (HR=0.94).
Conclusions:
- Surgical resection is recommended for elderly MM patients without contraindications.
- GTR does not offer a survival benefit over STR in the elderly.
- Further studies are needed to evaluate PORT efficacy in MM patients.
