Management of intracranial meningioma: Outcome analysis and clinico radiological profile of 172 patients

Surg Neurol Int. 2024 Dec 13:15:464. doi: 10.25259/SNI_556_2024. eCollection 2024.

Abstract

Background: Meningioma is the most common primary intracranial tumor. This single-center study aimed to analyze the clinicopathological, radiological profile, and outcomes of patients with intracranial meningiomas in terms of functional status, morbidity, mortality, and recurrence-free survival (RFS).

Methods: Patients of intracranial meningioma treated between January 01, 2010, and December 31, 2019, at the Department of Neurosurgery, King George's Medical University, India, were included in this study. Retrospective data analysis of 172 patients with intracranial meningioma was done.

Results: The majority of the patients, that is, 94 (54.65%), presented in the 4th and 5th decade. The mean size of the meningioma was 36.4 ± 4 mm (range: 26-68 mm). Of the 172 patients, 128 (74.41%) were diagnosed as non-skull base meningiomas, and in 44 patients (25.59%), meningioma originated from the skull base. Recurrence was observed on follow-up imaging in 11 patients after a mean postoperative interval of 55.2 ± 5.8 months. Radiological meningioma recurrence paralleled with clinical deterioration in seven patients. Three of these patients were subjected to the second surgery, followed by radiotherapy, and in the remaining four patients, Gamma knife or fractionated radiotherapy was given.

Conclusion: The majority of patients had good functional outcomes (KPS >70) at discharge. Morbidity and mortality was 18.60% and 3.49%, respectively. Meningioma size ≥4 cm, age >45 years, World Health Organization Grade (II, III), non-skull base location, and Simpson grade III, IV of resection showed significantly shorter RFS.

Keywords: Intracranial meningioma; Karnofsky performance scale score; Radiotherapy; Recurrence; Simpson grade.