Neurosurgical treatment and outcome patterns in patients with meningioma in South Moravian region-a population-based study

Abstract

Introduction: Meningiomas are usually slow-growing tumours, constituting about one third of all primary intracranial tumours. They occur more frequently in women. Clinical manifestation of meningiomas depends on their location, tumour size and growth rate. In most cases, surgical treatment is the procedure of choice. The success of this treatment is, however, associated with the radicality of the resection. Radiotherapy represents an additional or alternative treatment modality. Gamma knife surgery is another notable treatment method, especially in small and/or slow-growing tumours in eloquent areas or in elderly patients.

Material and methods: Authors describe their experience with the diagnosis, treatment and outcome of the patients with meningioma (n = 857). Furthermore, they also assess the postoperative morbidity/mortality and recurrence rate.

Results and conclusions: In view of the benign histology of meningiomas, the success of the treatment largely depends (besides the tumour grading) on the radicality of the resection. The emphasis is also put on appropriate follow-up of the patients. In certain patients, the watch and wait strategy should be also considered as a suitable treatment method.

Keywords: Diagnostics; Follow-up; Meningioma; Treatment.

Fig. 1

Baseline characteristics of the treatment modality of the whole group of patients (N = 857). SRS stereotactic radiosurgery

Fig. 2

Anatomical location of surgically treated meningiomas. CPA cerebellopontine angle

Fig. 3

The division of surgically treated meningiomas according to the histological results

Fig. 4

The division of surgically treated patients in accordance of radicality of resection classified after the Simpson grade (n = 774) [6]. Eighty-two percent of the patients underwent a complete resection with or without the resection of attached dura mater

Fig. 5

The table of CLASS score (ASA American Society of Anaesthesiologists, RT radiotherapy). The patients with the negative value should be considered for conservative treatment; on the other hand, if the patient achieves positive values, the surgery could be performed with a relative low risk of perioperative morbidity/mortality [29, 30]

Fig. 6

Geriatric Scoring Scale; deals with the pre-operative evaluation of the internal state of patients (GI gastrointestinal tract)