gms | German Medical Science

Objective: Intracranial meningiomas are usually stratified by location, extent of resection, WHO grading and histological subtypes, which influence postoperative treatment modalities and outcome. The aim of the present study was to evaluate gender differences in epidemiology, tumor characteristics and outcome for skull base meningiomas in comparison to convexity meningiomas.

Method: Of 1200 adult meningiomas, surgically treated in a single centre, between 1991 and 2010, complete perioperative and follow-up data were available in 396 patients with either skull-base (n=194) or convexity meningiomas (n=202). The patient charts were analyzed retrospectively for gender differences in histological grading, extent of resection, seizure prevalence, time to relapse and overall survival, respectively.

Results: We found an expected female predominance (2:1) for intracranial meningiomas, but no gender specific differences in the distribution between skull base and convexity. The extent of resection assessed by Simpson grading demonstrated a trend to less complete surgery in male patients (34,3 vs. 44%; p=0,054), which corresponded to higher WHO grades also in males (69,5/11,9/0,8 vs. 74,1/6,1/0,0%, WHO grade I/II/III respectively; p=0,05). 26% of the cohort suffered from epileptic seizures, which was significantly more common in men (35,9% vs. 20,1%; p=0,0001). There were no gender differences concerning the time to relapse or overall survival.

Conclusions: Distribution of intracranial meningiomas is unrelated to gender, whereas the extent of resection and the WHO grading is less favourable in male patients. The prevalence of seizures is significantly increased in men as well. The latter may not be related to pathophysiological features of the neoplasm but to gender specific factors.