2018Journal of Neurological Surgery Part B Skull BaseOpen access

Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

Jeff Ehresman, Tomás Garzón-Muvdi, Davis Rogers, Michael Lim, Gary L. Gallia, Jon Weingart, Henry Brem, Chetan Bettegowda, Kaisorn L. Chaichana

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Abstract

Objective Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are not clear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results Postoperatively from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (HR: 2.777 [95% CI: 1.229–5.942], p = 0.02), nonconvexity tumors (HR: 1.876 [95% CI: 1.051–3.532], p = 0.03), cerebello-pontine angle tumors (HR: 1.974 [95% CI: 1.019–3.672], p = 0.04), Simpson Grade IV resections (HR: 1.682 [95% CI: 1.056–2.660], p = 0.03), coronary artery disease (HR: 2.784 [95% CI: 1.173–6.187], p = 0.02), preoperative motor deficits (HR: 1.827 [95% CI: 1.054–3.080], p = 0.03), and preoperative cognitive deficits (HR: 1.838 [95% CI: 1.014–3.216], p = 0.05). Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

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What this paper is about

Objective Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are not clear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results Postoperatively from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (HR: 2.777 [95% CI: 1.229–5.942], p = 0.02), nonconvexity tumors (HR: 1.876 [95% CI: 1.051–3.532], p = 0.03), cerebello-pontine angle tumors (HR: 1.974 [95% CI: 1.019–3.672], p = 0.04), Simpson Grade IV resections (HR: 1.682 [95% CI: 1.056–2.660], p = 0.03), coronary artery disease (HR: 2.784 [95% CI: 1.173–6.187], p = 0.02), preoperative motor deficits (HR: 1.827 [95% CI: 1.054–3.080], p = 0.03), and preoperative cognitive deficits (HR: 1.838 [95% CI: 1.014–3.216], p = 0.05). Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

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Available abstract

Objective Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are not clear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results Postoperatively from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (HR: 2.777 [95% CI: 1.229–5.942], p = 0.02), nonconvexity tumors (HR: 1.876 [95% CI: 1.051–3.532], p = 0.03), cerebello-pontine angle tumors (HR: 1.974 [95% CI: 1.019–3.672], p = 0.04), Simpson Grade IV resections (HR: 1.682 [95% CI: 1.056–2.660], p = 0.03), coronary artery disease (HR: 2.784 [95% CI: 1.173–6.187], p = 0.02), preoperative motor deficits (HR: 1.827 [95% CI: 1.054–3.080], p = 0.03), and preoperative cognitive deficits (HR: 1.838 [95% CI: 1.014–3.216], p = 0.05). Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

Key concepts: Meningioma, Medicine, Intracranial tumor, Incidence (geometry), Resection, Surgical resection, Surgery, Radiology

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Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma — Research Paper | ScholarLens