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Sporadic multiple intracranial meningioma does not infer worse patient outcomes: results from a case control study
Abdurrahman I Islim1,2, Jing X Lee3, Mohammad A Mustafa4,5
1Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown Street, Liverpool, L69 7BE, UK. a.islim@doctors.org.uk.
Background:
Sporadic multiple meningioma are uncommon. Population-based data suggests that these patients have a reduced overall survival when compared to patients with solitary meningioma. The aim of this study was to investigate the clinical outcomes in multiple and solitary meningioma.
Methods:
A single-center matched cohort study (2008-2018) was performed. Patients with synchronous multiple meningioma at presentation, with no history of prior intracranial radiation, concurrent hormone replacement therapy or features of NF2-schwannomatosis were included. Eligible patients were matched 1:1 to patients with solitary meningioma. Outcomes of interest were occurrence of an intervention, recurrence, new meningioma development and mortality.
Results:
Thirty-four patients harboring 76 meningioma at presentation were included. Mean age was 59.3 years (SD = 13.5). Thirty-one (91.2%) were female. The median number of meningioma per patient was 2 (range 2-6). Eighteen patients (52.9%) were symptomatic at presentation. Median overall follow-up was 80.6 months (IQR 44.1-99.6). Compared to patients with a sporadic meningioma, there was no difference in intervention rates (67.6% vs 70.6%, P = 0.792). Eight patients (34.8%) with a multiple meningioma had a WHO grade 2 meningioma compared to 7 (29.2%) with a solitary meningioma (P = 0.679). Median recurrence-free survival was 89 months (95% CI 76-104) with no difference between the two groups (P = 0.209). Mean overall survival was 132 months (95% CI 127-138) with no difference between the two groups (P = 0.860). One patient with multiple meningioma developed two further new meningioma 36 months following diagnosis.
Conclusion:
Sporadic multiple meningioma may not have worse clinical outcomes. Management of patients with sporadic multiple meningioma should be tailored towards the symptomatic meningioma or high-risk asymptomatic meningioma.
Insights
Sporadic multiple meningioma may not lead to worse clinical outcomes compared to solitary meningioma. Management should focus on symptomatic or high-risk tumors in patients with multiple meningiomas.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Sporadic multiple meningiomas are rare and previously thought to be associated with reduced survival.
- This study aimed to compare clinical outcomes between multiple and solitary meningiomas.
Purpose of the Study:
- To investigate and compare the clinical outcomes of patients with sporadic multiple meningiomas versus solitary meningiomas.
- To evaluate differences in intervention rates, recurrence, new tumor development, and mortality.
Main Methods:
- A single-center matched cohort study was conducted from 2008 to 2018.
- Patients with synchronous multiple meningiomas were matched 1:1 with solitary meningioma patients.
- Exclusion criteria included prior radiation, hormone therapy, or neurofibromatosis type 2.
Main Results:
- Thirty-four patients with multiple meningiomas (76 tumors) were compared to solitary meningioma patients.
- No significant differences were observed in intervention rates (67.6% vs 70.6%), WHO grade 2 tumors (34.8% vs 29.2%), recurrence-free survival (89 months), or overall survival (132 months).
- One patient with multiple meningiomas developed two new tumors over the follow-up period.
Conclusions:
- Sporadic multiple meningiomas do not appear to be associated with worse clinical outcomes than solitary meningiomas.
- Treatment strategies for multiple meningiomas should be individualized based on tumor symptomatology and risk factors.
