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Non-operative meningiomas: long-term follow-up of 136 patients

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

Improving access to neuroradiology investigations has led to an increased rate of diagnosis of incidental meningiomas.

Method

A cohort of 136 incidental meningioma patients collected by a single neurosurgeon in a single neurosurgical centre is retrospectively analysed between 2002 and 2016. Demographic data, imaging and clinical features are presented. The radiological factors associated with meningiomas progression are also presented.

Results

The mean age at diagnosis was 65 (range, 33–94) years. Univariate analysis showed oedema was most strongly correlated with progression (p = 0.010) followed by hyperintensity in T2-weighted (T2W) MRI (p = 0.029) and in Flair-T2W MRI (p = 0.017). Isointensity in Flair-T2W MRI (0.004) was most strongly correlated with non-progression of the meningioma followed by calcification (p = 0.007), older age (p = 0.087), hypointensity in Flair-T2W MRI (p = 0.014) sequences and in T2W MRI (p = 0.096). In multivariate analysis, the strongest radiological factor predictive of progression was peritumoural oedema (p = 0.016) and that of non-progression was calcification (p = 0.002). At the end of the median follow-up (FU) of 43 (range, 4–150) months, 109 (80%) patients remained clinically stable, 13 (10%) became symptomatic and 14 (10%) showed clinical and radiological progression.

Conclusions

One hundred and nine (80%) patients remained stable at the end of FU. Peritumoural oedema was predictive of meningiomas progression. Further prospective study is needed to identify the combination of factors which can predict the meningioma progression for an early surgery or early discharge.

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Authors and Affiliations

  1. Department of Neurosurgery, Charing Cross Hospital, Imperial College NHS Trust, Fulham Palace Rd, London, W6 8RF, UK

    Rossana Romani

  2. Department of Neurosurgery, Essex Neuroscience Centre, Queen’s Hospital, Romford, RM7 0AG, UK

    George Ryan & Jonathan Pollock

  3. Department of Mathematics and Statistics, University of Helsinki, 2b, P.O. Box 68, FI-00014, Helsinki, Finland

    Christian Benner

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  1. Rossana Romani
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  2. George Ryan
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Correspondence to Rossana Romani.

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The authors declare that they have no conflict of interest.

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All procedures of this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Romani, R., Ryan, G., Benner, C. et al. Non-operative meningiomas: long-term follow-up of 136 patients. Acta Neurochir 160, 1547–1553 (2018). https://doi.org/10.1007/s00701-018-3554-4

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  • DOI: https://doi.org/10.1007/s00701-018-3554-4

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