Authors: Judith Scheitzach KarlMichael Schebesch Alexander Brawanski Martin A Proescholdt
Publish Date: 2013/11/21
Volume: 116, Issue: 2, Pages: 381-386
Abstract
Microsurgical resection is the primary treatment of skull base meningiomas Maximal resection provides the best tumor control rates but can be associated with high surgical morbidity To understand the relation between extent of resection EOR and functional outcome we have analyzed the neurological improvement and recurrence rate in a large consecutive series of skull base meningioma patients In addition we defined anatomical and biological factors predictive for recurrence and overall outcome We investigated 226 skull base meningioma patients receiving tumor resection in our institution The most frequent location was the medial sphenoid ridge 296 EOR was rated according to the Simpson scale Overall performance was measured by the Karnofsky performance score KPS neurological deficits were quantified using the Medical Research Council Neurological Severity Score MRCNPS Complete resection was achieved in 628 and the EOR was significantly correlated to tumor location The morbidity and mortality rate was 321 and 27 respectively new permanent neurological deficits occurred in 35 of all patients From all patients with focal neurological deficits 601 experienced significant improvement Both the MRCNPS and the KPS significantly improved from the preoperative status to discharge however the improvement rate was dependent on the tumor location Recurrence rate was 155 tumor size bone and venous sinus infiltration WHO grade poor EOR but not MIB1 labeling index were independent factors predictive for recurrence Microsurgical resection of skull base meningiomas improves neurological impairment in the majority of patients Specific risk factors for recurrence require consideration for postoperative management
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