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Published in: Neurosurgical Review 1/2019

01-03-2019 | Original Article

Meningiomas: skull base versus non-skull base

Authors: Torstein R. Meling, Michele Da Broi, David Scheie, Eirik Helseth

Published in: Neurosurgical Review | Issue 1/2019

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Abstract

To identify differences between skull base meningiomas (SBM) and non-skull base meningiomas (NSBM). All adult patients (18.0–69.9 years) operated for intracranial meningiomas between 1990 and 2010 at our institution were investigated. Al-Mefty’s definition was used to dichotomize tumors into SBM and NSBM. Overall, 1148 consecutive patients were identified. Median age at surgery was 54.2 years [18.1–69.9]. Median follow-up was 7.4 years [0.0–20.9]. There were 562 patients (49%) with SBM and 586 (51%) with NSBM. The two groups were similar with respect to patient age, follow-up time, and number of patients. Overall female-to-male ratio was 2.6:1, but 3.2:1 in SBM and 2.2:1 in NSBM (p < 0.005). With respect to presenting symptoms, SBMs had more often neurological deficits (risk ratio (RR) 1.4; p < 0.0001) and less often seizures (RR 0.4; p < 0.0001). Gross total resections were less frequent in SBM than NSBM (62 vs 84%) (RR 1.3; p < 0.0001). SBMs had a lower risk of WHO grades II and III histology (4.5 vs 9.5%) (RR 0.5; p < 0.001). Worsening of neurological function was more frequent in SBM (21 vs 121%) (RR 1.8; p < 0.001). Retreatment-free survival at 5, 10, and 15 years, respectively, was 80, 70, and 62% for SBM versus 90, 82, and 74% for NSBM (p < 0.0001). Overall survival at 5, 10, and 15 years, respectively, was 93, 85, and 78% for SBM and 96, 91, and 79% for NSBM (p = 0.14). Patients with SBMs had more new-onset neurological deficits and significantly shorter retreatment-free survivals, but this did not adversely affect the overall survival.
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Metadata
Title
Meningiomas: skull base versus non-skull base
Authors
Torstein R. Meling
Michele Da Broi
David Scheie
Eirik Helseth
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Neurosurgical Review / Issue 1/2019
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-018-0976-7

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