Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Apr;142(2):211-221.
doi: 10.1007/s11060-019-03104-3. Epub 2019 Jan 17.

Incidental intracranial meningiomas: a systematic review and meta-analysis of prognostic factors and outcomes

Abdurrahman I Islim  1   2   3 , Midhun Mohan  4   5 , Richard D C Moon  4   5 , Nisaharan Srikandarajah  6   5 , Samantha J Mills  7 , Andrew R Brodbelt  5 , Michael D Jenkinson  6   5
Affiliations
Meta-Analysis

Incidental intracranial meningiomas: a systematic review and meta-analysis of prognostic factors and outcomes

Abdurrahman I Islim et al. J Neurooncol. 2019 Apr.

Erratum in

Abstract

Background: Incidental discovery accounts for 30% of newly-diagnosed intracranial meningiomas. There is no consensus on their optimal management. This review aimed to evaluate the outcomes of different management strategies for these tumors.

Methods: Using established systematic review methods, six databases were scanned up to September 2017. Pooled event proportions were estimated using a random effects model. Meta-regression of prognostic factors was performed using individual patient data.

Results: Twenty studies (2130 patients) were included. Initial management strategies at diagnosis were: surgery (27.3%), stereotactic radiosurgery (22.0%) and active monitoring (50.7%) with a weighted mean follow-up of 49.5 months (SD = 29.3). The definition of meningioma growth and monitoring regimens varied widely impeding relevant meta-analysis. The pooled risk of symptom development in patients actively monitored was 8.1% (95% CI 2.7-16.1). Associated factors were peritumoral edema (OR 8.72 [95% CI 0.35-14.90]) and meningioma diameter ≥ 3 cm (OR 34.90 [95% CI 5.17-160.40]). The pooled proportion of intervention after a duration of active monitoring was 24.8% (95% CI 7.5-48.0). Weighted mean time-to-intervention was 24.8 months (SD = 18.2). The pooled risks of morbidity following surgery and radiosurgery, accounting for cross-over, were 11.8% (95% CI 3.7-23.5) and 32.0% (95% CI 10.6-70.5) respectively. The pooled proportion of operated meningioma being WHO grade I was 94.0% (95% CI 88.2-97.9).

Conclusion: The management of incidental meningioma varies widely. Most patients who clinically or radiologically progressed did so within 5 years of diagnosis. Intervention at diagnosis may lead to unnecessary overtreatment. Prospective data is needed to develop a risk calculator to better inform management strategies.

Keywords: Asymptomatic; Incidental; Meningioma; Meta-analysis; Systematic review.

PubMed Disclaimer

Conflict of interest statement

A.I.I., M.M., R.D.C.M., N.S., S.J.M., A.R.B. and M.D.J. have no relevant financial relationships or conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
PRISMA flowchart demonstrating the study selection process
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Morris Z, Whiteley WN, Longstreth WT, Jr, Weber F, Lee YC, Tsushima Y, Alphs H, Ladd SC, Warlow C, Wardlaw JM, Al-Shahi Salman R. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2009;339:b3016. doi: 10.1136/bmj.b3016. - DOI - PMC - PubMed
    1. Hayward R. VOMIT (victims of modern imaging technology)—an acronym for our times. BMJ. 2003;326:1273. doi: 10.1136/bmj.326.7401.1273. - DOI
    1. Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, von Deimling A, Stavrinou P, Lefranc F, Lund-Johansen M, Moyal EC, Brandsma D, Henriksson R, Soffietti R, Weller M. EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol. 2016;17:e383–e391. doi: 10.1016/S1470-2045(16)30321-7. - DOI - PubMed
    1. de Boer AW, Drewes YM, de Mutsert R, Numans ME, den Heijer M, Dekkers OM, de Roos A, Lamb HJ, Blom JW, Reis R. Incidental findings in research: A focus group study about the perspective of the research participant. J Magn Reson Imaging. 2017 - PubMed
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009 - PMC - PubMed

LinkOut - more resources