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Single versus multiple reoperations for recurrent intracranial meningiomas
Francesco Maiuri1, Sergio Corvino2, Giuseppe Corazzelli1
1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University "Federico II" of Naples, 80131, Naples, Italy.
Journal of Neuro-Oncology
|April 24, 2024
Summary
Incomplete resection and diffuse tumor regrowth are key risks for multiple intracranial meningioma recurrences. Repeated surgeries, even partial, can prolong survival before malignant transformation.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Intracranial meningiomas can recur, necessitating reoperation.
- Understanding risk factors for multiple recurrences is crucial for patient management.
Purpose of the Study:
- To identify risk factors for multiple recurrences and reoperations in intracranial meningiomas.
- To evaluate management strategies for recurrent meningiomas.
Main Methods:
- Retrospective review of 35 patients undergoing reoperation for recurrent intracranial meningiomas.
- Analysis of patient demographics, tumor characteristics (WHO grade, Ki67-MIB1, PR expression), surgical extent, and recurrence patterns.
- Stratification into single (Group A) and multiple reoperation (Group B) cohorts.
Main Results:
- Age < 65, male sex, incomplete initial and first reoperation resection, and multicentric-diffuse regrowth patterns were risk factors for multiple reoperations.
- WHO grade and Ki67-MIB1 increased in subsequent recurrences for 54% and 64% of Group B patients, respectively.
- Long-term survival (7-22 years) was achieved in 73% of patients after 2-4 reoperations.
Conclusions:
- Extent of resection and multicentric-diffuse regrowth at first recurrence are primary risk factors for multiple reoperations.
- Repeated reoperations, even partial, are advisable before anaplastic transformation.
- Combined surgical and radiation approaches can lead to long-term survival in good clinical condition.
