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J Neurol Surg A Cent Eur Neurosurg 2015; 76(05): 341-347
DOI: 10.1055/s-0034-1543959
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Will an Asymptomatic Meningioma Grow or Not Grow? A Meta-analysis

Lingcheng Zeng
1   Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
,
Pei Liang
2   Sensory Science Laboratory, School of Bioscience and Food Engineering, Changshu Institute of Technology, China
,
Jiantong Jiao
1   Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
,
Jian Chen
1   Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
,
Ting Lei
1   Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
› Author Affiliations
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Publication History

06 May 2014

24 October 2014

Publication Date:
23 March 2015 (online)

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Abstract

Background The treatment strategy for patients with an asymptomatic meningioma is still controversial. Key to an optimal decision is a careful evaluation of the growth possibilities of the meningioma by taking the patient's clinicoradiologic factors into consideration. However, previous studies have disagreed about the risk factors relating to tumor growth.

Methods A comprehensive search of PubMed, Embase, and the ISI Web of Knowledge was performed. Using a meta-analysis with nine subsidiary studies including 777 patients, we analyzed the correlation of the growth pattern of meningioma with patient gender, tumor location, tumor calcification, magnetic resonance imaging (MRI) T2 signal intensity, and peritumoral brain edema.

Results The growth rate of meningioma was negatively correlated with tumor calcification (odds ratio [OR]: 0.23; 95% confidence interval (CI), 0.11–0.46; p < 0.001) but positively associated with MRI T2 signal intensity (OR: 2.75; 95% CI, 1.75–4.33; p < 0.001). No correlations were found between tumor growth and other factors such as gender (OR: 1.29; 95% CI, 0.84–1.99; p = 0.24), skull base location (OR: 0.80; 95% CI, 0.25–2.58; p = 0.70), and peritumoral brain edema (OR: 1.24; 95% CI, 0.29–5.27; p = 0.77).

Conclusions Two factors, tumor calcification and low MRI T2 signal intensity, indicate the possibility of a slow growth meningioma. In such cases of asymptomatic meningioma, a follow-up strategy can be preferentially considered.

Keywords

asymptomatic meningioma - natural history - meta-analysis
 

  • References

  • 1 Whittle IR, Smith C, Navoo P, Collie D. Meningiomas. Lancet 2004; 363 (9420) 1535-1543
    CrossrefPubMedGoogle Scholar
  • 2 Chamoun R, Krisht KM, Couldwell WT. Incidental meningiomas. Neurosurg Focus 2011; 31 (6) E19
    CrossrefPubMedGoogle Scholar
  • 3 Go RS, Taylor BV, Kimmel DW. The natural history of asymptomatic meningiomas in Olmsted County, Minnesota. Neurology 1998; 51 (6) 1718-1720
    CrossrefPubMedGoogle Scholar
  • 4 Yano S, Kuratsu J ; Kumamoto Brain Tumor Research Group. Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience. J Neurosurg 2006; 105 (4) 538-543
    CrossrefPubMedGoogle Scholar
  • 5 Firsching RP, Fischer A, Peters R, Thun F, Klug N. Growth rate of incidental meningiomas. J Neurosurg 1990; 73 (4) 545-547
    CrossrefPubMedGoogle Scholar
  • 6 Braunstein JB, Vick NA. Meningiomas: the decision not to operate. Neurology 1997; 48 (5) 1459-1462
    CrossrefPubMedGoogle Scholar
  • 7 Staneczek W, Jänisch W. Epidemiologic data on meningiomas in East Germany 1961–1986: incidence, localization, age and sex distribution. Clin Neuropathol 1992; 11 (3) 135-141
    PubMedGoogle Scholar
  • 8 Hashimoto N, Rabo CS, Okita Y , et al. Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies. J Neurosurg 2012; 116 (3) 574-580
    CrossrefPubMedGoogle Scholar
  • 9 Rubin G, Herscovici Z, Laviv Y, Jackson S, Rappaport ZH. Outcome of untreated meningiomas. Isr Med Assoc J 2011; 13 (3) 157-160
    PubMedGoogle Scholar
  • 10 Oya S, Kim SH, Sade B, Lee JH. The natural history of intracranial meningiomas. J Neurosurg 2011; 114 (5) 1250-1256
    PubMedGoogle Scholar
  • 11 Pravdenkova S, Al-Mefty O, Sawyer J, Husain M. Progesterone and estrogen receptors: opposing prognostic indicators in meningiomas. J Neurosurg 2006; 105 (2) 163-173
    CrossrefPubMedGoogle Scholar
  • 12 Kasuya H, Kubo O, Tanaka M, Amano K, Kato K, Hori T. Clinical and radiological features related to the growth potential of meningioma. Neurosurg Rev 2006; 29 (4) 293-296 ; discussion 296–297
    CrossrefPubMedGoogle Scholar
  • 13 Nakasu S, Nakajima M, Matsumura K, Nakasu Y, Handa J. Meningioma: proliferating potential and clinicoradiological features. Neurosurgery 1995; 37 (6) 1049-1055
    CrossrefPubMedGoogle Scholar
  • 14 Hashiba T, Hashimoto N, Maruno M , et al. Scoring radiologic characteristics to predict proliferative potential in meningiomas. Brain Tumor Pathol 2006; 23 (1) 49-54
    CrossrefPubMedGoogle Scholar
  • 15 Hashiba T, Hashimoto N, Izumoto S , et al. Serial volumetric assessment of the natural history and growth pattern of incidentally discovered meningiomas. J Neurosurg 2009; 110 (4) 675-684
    CrossrefPubMedGoogle Scholar
  • 16 Di Maio S, Ramanathan D, Garcia-Lopez R , et al. Evolution and future of skull base surgery: the paradigm of skull base meningiomas. World Neurosurg 2012; 78 (3–4) 260-275
    CrossrefPubMedGoogle Scholar
  • 17 Kizana E, Lee R, Young N, Dorsch NW, Soo YS. A review of the radiological features of intracranial meningiomas. Australas Radiol 1996; 40 (4) 454-462
    CrossrefPubMedGoogle Scholar
  • 18 Niiro M, Yatsushiro K, Nakamura K, Kawahara Y, Kuratsu J. Natural history of elderly patients with asymptomatic meningiomas. J Neurol Neurosurg Psychiatry 2000; 68 (1) 25-28
    CrossrefPubMedGoogle Scholar
  • 19 Kuratsu J, Kochi M, Ushio Y. Incidence and clinical features of asymptomatic meningiomas. J Neurosurg 2000; 92 (5) 766-770
    CrossrefPubMedGoogle Scholar
  • 20 Sitthinamsuwan B, Khampalikit I, Nunta-aree S, Srirabheebhat P, Witthiwej T, Nitising A. Predictors of meningioma consistency: a study in 243 consecutive cases. Acta Neurochir (Wien) 2012; 154 (8) 1383-1389
    CrossrefPubMedGoogle Scholar
  • 21 Tenner MS, Spiller M, Koenig SH , et al. Calcification can shorten T2, but not T1, at magnetic resonance imaging fields. Results of a relaxometry study of calcified human meningiomas. Invest Radiol 1995; 30 (6) 345-353
    CrossrefPubMedGoogle Scholar
  • 22 Lobato RD, Alday R, Gómez PA , et al. Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema. Acta Neurochir (Wien) 1996; 138 (5) 485-493 ; discussion 493–494
    CrossrefPubMedGoogle Scholar
  • 23 Vignes JR, Sesay M, Rezajooi K, Gimbert E, Liguoro D. Peritumoral edema and prognosis in intracranial meningioma surgery. J Clin Neurosci 2008; 15 (7) 764-768
    CrossrefPubMedGoogle Scholar
  • 24 Nakano T, Asano K, Miura H, Itoh S, Suzuki S. Meningiomas with brain edema: radiological characteristics on MRI and review of the literature. Clin Imaging 2002; 26 (4) 243-249
    CrossrefPubMedGoogle Scholar
  • 25 Oya S, Sade B, Lee JH. Benefits and limitations of diameter measurement in the conservative management of meningiomas. Surg Neurol Int 2011; 2: 158
    CrossrefPubMedGoogle Scholar
  • 26 Yoneoka Y, Fujii Y, Tanaka R. Growth of incidental meningiomas. Acta Neurochir (Wien) 2000; 142 (5) 507-511
    CrossrefPubMedGoogle Scholar
  • 27 Couldwell WT. Asymptomatic meningiomas. J Neurosurg 2006; 105 (4) 536-537 ; discussion 537
    CrossrefPubMedGoogle Scholar
  • 28 Nakamura M, Roser F, Michel J, Jacobs C, Samii M. The natural history of incidental meningiomas. Neurosurgery 2003; 53 (1) 62-70 ; discussion 70–71
    CrossrefPubMedGoogle Scholar
  • 29 Olivero WC, Lister JR, Elwood PW. The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients. J Neurosurg 1995; 83 (2) 222-224
    CrossrefPubMedGoogle Scholar
  • 30 Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G. Natural history of conservatively treated meningiomas. Neurology 2004; 63 (6) 1133-1134
    CrossrefPubMedGoogle Scholar