Association between meningioma consistency and surgical outcomes

Area of Science:

• Neurosurgery
• Oncology
• Surgical Pathology

Background:

• Meningioma consistency (fibrosity) influences surgical resection, particularly with minimally invasive techniques.
• A validated 5-point scale exists for intraoperative grading of meningioma consistency.
• The impact of meningioma consistency on surgical management and outcomes requires further exploration.

Purpose of the Study:

• To determine associations between meningioma consistency and presenting symptoms.
• To investigate relationships between meningioma consistency and tumor characteristics.
• To evaluate the impact of meningioma consistency on postoperative outcomes.

Main Methods:

• Intraoperative grading of 209 surgically resected meningiomas using a 5-point consistency scale (grade 1: soft, grade 5: firm/calcified).
• Prospective collection of presenting symptoms, tumor characteristics, and postoperative complications.
• Analysis of consistency in three categories (grades 1-2, grade 3, grades 4-5) using ANOVA, chi-square/Fisher's exact tests, and univariable logistic regression.

Main Results:

• Higher consistency meningiomas (grades 4-5) were associated with lower rates of gross-total resection (OR 0.24) and increased invasiveness (OR 4.73).
• Firmer tumors correlated with higher rates of tumor recurrence (OR 3.30), reoperation (OR 3.08), and complications (OR 2.08).
• No significant associations were found between consistency and preoperative symptoms, tumor size, or surgery duration.

Conclusions:

• Meningioma tumor consistency is significantly associated with key tumor characteristics and perioperative outcomes.
• Preoperative assessment of meningioma consistency via advanced imaging is crucial for surgical planning.
• Understanding consistency aids in anticipating outcomes and complications, guiding resection strategies.