Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study

Abstract Meningiomas are benign tumors that are treated surgically. Local recurrence is likely if the dura is preserved, and en bloc tumor and dura resection (Simpson grade I) is recommended. In some cases the dura is cauterized and preserved after tumor resection (Simpson grade II). The purpose of...

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Autores principales:	Kazuyoshi Kobayashi, Kei Ando, Tomohiro Matsumoto, Koji Sato, Fumihiko Kato, Tokumi Kanemura, Hisatake Yoshihara, Yoshihito Sakai, Atsuhiko Hirasawa, Hiroaki Nakashima, Shiro Imagama
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/86ecd9cd23c541198204bd101024222d
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spelling	oai:doaj.org-article:86ecd9cd23c541198204bd101024222d2021-12-02T18:24:54ZClinical features and prognostic factors in spinal meningioma surgery from a multicenter study10.1038/s41598-021-91225-z2045-2322https://doaj.org/article/86ecd9cd23c541198204bd101024222d2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91225-zhttps://doaj.org/toc/2045-2322Abstract Meningiomas are benign tumors that are treated surgically. Local recurrence is likely if the dura is preserved, and en bloc tumor and dura resection (Simpson grade I) is recommended. In some cases the dura is cauterized and preserved after tumor resection (Simpson grade II). The purpose of this study was performed to analyze clinical features and prognostic factors associated with spinal meningioma, and to identify the most effective surgical treatment. The subjects were 116 patients (22 males, 94 females) with spinal meningioma who underwent surgery at seven NSG centers between 1998 and 2018. Clinical data were collected from the NSG database. Pre- and postoperative neurological status was defined using the modified McCormick scale. The patients had a mean age of 61.2 ± 14.8 years (range 19–91 years) and mean symptom duration of 11.3 ± 14.7 months (range 1–93 months). Complete resection was achieved in 108 cases (94%), including 29 Simpson grade I and 79 Simpson grade II resections. The mean follow-up period was 84.8 ± 52.7 months. At the last follow-up, neurological function had improved in 73 patients (63%), was stable in 34 (29%), and had worsened in 9 (8%). Eight patients had recurrence, and recurrence rates did not differ significantly between Simpson grades I and II in initial surgery. Kaplan–Meier analysis of recurrence-free survival showed that Simpson grade III or IV, male, and dural tail sign were significant factors associated with recurrence (P < 0.05). In conclusion, Simpson I resection is anatomically favorable for spinal meningiomas. Younger male patients with a dural tail and a high-grade tumor require close follow-up. The tumor location and feasibility of surgery can affect the surgical morbidity in Simpson I or II resection. All patients should be carefully monitored for long-term outcomes, and we recommend lifelong surveillance after surgery.Kazuyoshi KobayashiKei AndoTomohiro MatsumotoKoji SatoFumihiko KatoTokumi KanemuraHisatake YoshiharaYoshihito SakaiAtsuhiko HirasawaHiroaki NakashimaShiro ImagamaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kazuyoshi Kobayashi Kei Ando Tomohiro Matsumoto Koji Sato Fumihiko Kato Tokumi Kanemura Hisatake Yoshihara Yoshihito Sakai Atsuhiko Hirasawa Hiroaki Nakashima Shiro Imagama Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
description	Abstract Meningiomas are benign tumors that are treated surgically. Local recurrence is likely if the dura is preserved, and en bloc tumor and dura resection (Simpson grade I) is recommended. In some cases the dura is cauterized and preserved after tumor resection (Simpson grade II). The purpose of this study was performed to analyze clinical features and prognostic factors associated with spinal meningioma, and to identify the most effective surgical treatment. The subjects were 116 patients (22 males, 94 females) with spinal meningioma who underwent surgery at seven NSG centers between 1998 and 2018. Clinical data were collected from the NSG database. Pre- and postoperative neurological status was defined using the modified McCormick scale. The patients had a mean age of 61.2 ± 14.8 years (range 19–91 years) and mean symptom duration of 11.3 ± 14.7 months (range 1–93 months). Complete resection was achieved in 108 cases (94%), including 29 Simpson grade I and 79 Simpson grade II resections. The mean follow-up period was 84.8 ± 52.7 months. At the last follow-up, neurological function had improved in 73 patients (63%), was stable in 34 (29%), and had worsened in 9 (8%). Eight patients had recurrence, and recurrence rates did not differ significantly between Simpson grades I and II in initial surgery. Kaplan–Meier analysis of recurrence-free survival showed that Simpson grade III or IV, male, and dural tail sign were significant factors associated with recurrence (P < 0.05). In conclusion, Simpson I resection is anatomically favorable for spinal meningiomas. Younger male patients with a dural tail and a high-grade tumor require close follow-up. The tumor location and feasibility of surgery can affect the surgical morbidity in Simpson I or II resection. All patients should be carefully monitored for long-term outcomes, and we recommend lifelong surveillance after surgery.
format	article
author	Kazuyoshi Kobayashi Kei Ando Tomohiro Matsumoto Koji Sato Fumihiko Kato Tokumi Kanemura Hisatake Yoshihara Yoshihito Sakai Atsuhiko Hirasawa Hiroaki Nakashima Shiro Imagama
author_facet	Kazuyoshi Kobayashi Kei Ando Tomohiro Matsumoto Koji Sato Fumihiko Kato Tokumi Kanemura Hisatake Yoshihara Yoshihito Sakai Atsuhiko Hirasawa Hiroaki Nakashima Shiro Imagama
author_sort	Kazuyoshi Kobayashi
title	Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
title_short	Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
title_full	Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
title_fullStr	Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
title_full_unstemmed	Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
title_sort	clinical features and prognostic factors in spinal meningioma surgery from a multicenter study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/86ecd9cd23c541198204bd101024222d
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Clinical features and prognostic factors in spinal meningioma surgery from a multicenter study

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