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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Parasagittal and sinus-infiltrating meningiomas – analysis of growth pattern, extent of resection and outcome

Meeting Abstract

  • Judith Anthofer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Germany
  • Rahel Seidel-Schulz - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Germany
  • Martin Proescholdt - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Germany
  • Alexander Brawanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Germany
  • Karl-Michael Schebesch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.04.04

doi: 10.3205/16dgnc018, urn:nbn:de:0183-16dgnc0188

Veröffentlicht: 8. Juni 2016

© 2016 Anthofer et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Surgical treatment of the subgroup of parasagittal meningiomas is difficult due to irregular growth patterns and infiltration of the venous sinuses. To evaluate the postoperative clinical course of this subgroup, we conducted a retrospective study in a large population of patients with cranial meningiomas localized next to a major sinus.

Method: We included all consecutive patients that had been treated in our department between 2000 and 2012 with a meningioma located within 20 mm to a major venous sinus (superior parasagittal sinus, transverse sinus, sigmoid sinus, confluent sinus). We reviewed the charts and the surgical reports for demographics, histology, neurological performance pre-, postoperatively and during follow-up. Radiographic imaging was screened for tumor extension, infiltration of the skull, sinus infiltration (Sindou grade), extent of resection (EOR; Simpson grade) and tumor recurrence.

Results: 829 patients with cranial meningiomas have been identified and screened. 141 patients with parasinusoidal meningiomas and complete datasets were included (109 female, 32 male, range 24-89 years). Complete resection (Simpson Grade I or II) was achieved in 107 patients (75%). Direct postoperative neurological improvement was found in 55% (n=37) of patients with preoperative neurological deficits (n=67). MRCNPS (Medical Research Council-Neurological Performance Status) improved in 24.1% of patients postoperatively, and KPS (Karnofsky Performance Score) in 55.3% throughout follow-up. The follow-up was up to 13.5 years. Local tumor recurrence was detected in 10.8% (n=15) during follow-up. Multivariate analysis (multiple logistic regression) revealed higher WHO grading and tumor size as independently predictive for local tumor recurrence (p=0.03 and p=0.001, respectively). Patients with recurrent tumors had significantly more frequently patterns of skull invasion (p=0.002).

Conclusions: Surgical removal of parasagittal and sinus-infiltrating meningiomas is beneficial in terms of neurological improvement and local tumor control. However, tumor size and skull infiltration are important predictors of tumor recurrence. Furthermore, our data revealed that recurrent tumors are characterized by a higher WHO grading.