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Benign meningiomas: primary treatment selection affects survival

K S Condra1, J M Buatti, W M Mendenhall

  • 1Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.

International Journal of Radiation Oncology, Biology, Physics
|October 6, 1997
PubMed
Summary

For benign intracranial meningiomas, total excision or subtotal excision plus radiotherapy offers better outcomes than subtotal excision alone. Atypical features and recurrence indicate poorer survival, emphasizing the importance of primary treatment selection.

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Area of Science:

  • Neurosurgery
  • Oncology
  • Radiation Oncology

Background:

  • Benign intracranial meningiomas are common primary tumors of the central nervous system.
  • Treatment selection is crucial for optimizing patient outcomes and preventing recurrence.

Purpose of the Study:

  • To evaluate the impact of primary treatment modality on local control and cause-specific survival for benign intracranial meningiomas.
  • To identify factors influencing outcomes in patients treated at the University of Florida.

Main Methods:

  • A retrospective analysis of 262 patients with benign intracranial meningiomas.
  • Evaluation of age, Karnofsky performance status, tumor characteristics, and treatment modality (surgery alone, surgery + radiotherapy, radiotherapy alone, radiosurgery alone).
  • Kaplan-Meier survival analysis with univariate and multivariate assessments.

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Main Results:

  • Total excision (TE) and subtotal excision plus radiotherapy (SE+RT) achieved significantly better local control and cause-specific survival at 15 years compared to subtotal excision (SE) alone.
  • Recurrence after primary treatment was associated with decreased survival.
  • Atypical pathologic features and lower Karnofsky performance status predicted poorer outcomes.

Conclusions:

  • Total excision or subtotal excision plus radiotherapy are effective management strategies for benign meningiomas.
  • Subtotal excision alone is insufficient and negatively impacts survival.
  • Atypical features may warrant more aggressive treatment, and primary treatment choice is critical due to the impact of recurrence on survival.