gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Article

Send article

Tumour recurrence and functional outcome following spinal meningioma surgery – institutional experience with 123 cases

Tumorrezidiv und funktionelles Outcome nach chirurgischer Therapie spinaler Meningeome – institutionelle Erfahrung mit 123 Fällen

Meeting Abstract

Search Medline for

  • presenting/speaker Johannes Wach - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Mohammed Banat - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland
  • Jasmin E. Scorzin - Universitätsklinikum Bonn, Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV228

doi: 10.3205/20dgnc225, urn:nbn:de:0183-20dgnc2256

Published: June 26, 2020

© 2020 Wach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Spinal meningiomas (SM) account for 2% of all meningiomas. Clinicoradiological and immunohistochemical factors were analysed with regard to the prediction of tumour recurrence and functional outcome.

Methods: Medical records of 123 patients who underwent surgery for SM between 2000 and 2019 were retrospectively reviewed with regard to demographic parameters, imaging features, surgical workflow, immunohistochemical items, neurological outcome and recurrence. Dural attachment, T2 hyperintensity of spinal cord, dural tail sign, tumour size, Simpson Grade, spinal level, medical history and histopathology were analysed to predict tumour recurrence and functional outcome. Neurological function was graded according to the Modified McCormick Scale (MMS) and dichotomized into to "good (I+II)" and "poor (III-V)" function.

Results: 114 (92.7%) WHO grade I and 9 (7.3%) WHO grade II SMs were included in this study. Univariate analysis identified baseline T2 hyperintensity of the spinal cord, prolonged duration of baseline symptoms (≥4 weeks), age ≥66 years and dural tail sign as predictors of poor MMSs.

Baseline T2 hyperintensity of the spinal cord (OR=13.3, 95% CI=3.4-52.4, p<0.001) and age ≥ 66 years (OR=10.3, 95% CI=2.6-41.1, p=0.001) were the only independent predictors of poor MMSs at discharge in the binary logistic regression analysis.

Median (range) follow-up (including MRI surveillance) was 12.0 (3.0-120.0) months in 80 cases. 2 (1.6%) recurrences were observed. Kaplan-Meier analysis (log-rank test)showed that WHO grade II, cervical location, ventral tumour attachment, male sex, Diabetes, Simpson Grade (III&IV), and MIB-I index ≥5% were significant associated with an increased risk of recurrence.

Cox regression analysis revealed the MIB-1 labeling index ≥ 5% as an independent risk factor for recurrence (HR: 1.77, 95% CI: 1.01-3.11, p=0.047).

Conclusion: Baseline T2 hyperintensity, especially in the elderly patients should be reminded as far as functional outcome following surgical resection of spinal meningiomas is concerned. A policy of maximal safe resection of SMs prolongs recurrence-free survival inspinal meningiomashaving high proliferative activity.