Recurrence of cranial base meningiomas

Area of Science:

• Neurosurgery
• Oncology
• Pathology

Background:

• Long-term data on traditionally treated cranial base meningiomas are crucial for assessing modern surgical techniques.
• Understanding the natural history of these tumors informs decisions regarding nonradical surgical approaches.

Purpose of the Study:

• To evaluate the long-term outcomes of cranial base meningiomas treated before the era of advanced surgical techniques.
• To provide data for comparing traditional treatments with modern cranial base surgery.
• To determine the long-term efficacy and necessity of nonradical surgical interventions.

Main Methods:

• Retrospective review of 315 patients operated on between 1947 and 1982.
• Analysis of perioperative mortality, 10-year mortality, and long-term follow-up (10-36 years).
• Assessment of recurrence rates and symptomatic progression based on surgical grades (1-5).

Main Results:

• 5-year recurrence rates varied from 4% (radical surgery) to 25-45% (nonradical surgery).
• Long-term follow-up revealed symptomatic recurrences in 16-20% of Grade 1-2 patients and progression in most Grade 4-5 patients.
• Tumor progression or recurrence typically occurred within 10 years, but late recurrences were observed up to 25 years; medial sphenoid wing/clinoidal and cavernous sinus-invading tumors had the worst outcomes.

Conclusions:

• Management of cranial base meningiomas requires a 10- to 20-year perspective.
• Continuous patient follow-up is necessary to evaluate treatment effectiveness and detect recurrences.
• Nonradical surgery should be considered palliative; further research into radical treatment options is warranted for these challenging tumors.