Spinal meningiomas: is Simpson grade II resection radical enough?

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F20%3A10411781" target="_blank" >RIV/00216208:11110/20:10411781 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/61383082:_____/20:00000692

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=eyDFCi3HOG" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=eyDFCi3HOG</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00701-020-04280-2" target="_blank" >10.1007/s00701-020-04280-2</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Spinal meningiomas: is Simpson grade II resection radical enough?

Popis výsledku v původním jazyce

Background: The optimal treatment for spinal meningioma is complete resection. The radicality of resection is the most important predictive factor for future tumor recurrence. Although clinical series dedicated to spinal meningiomas are relatively frequent, only a minimum of these defines the length of the required follow-up and difference in tumor recurrence in the context of Simpson grade I and II resection. Therefore, we propose reconsideration of surgical treatment and long-term follow-up based on a retrospective analysis of 84 patients who underwent Simpson grade II resection. Methods: The study included 84 patients operated between 1998 and 2018. Clinical symptomatology, age, sex, risk of comorbidities, spinal level, duration of symptoms, surgical resection radicality, tumor recurrence, and complications associated with treatment were recorded and evaluated. Results: We encountered the diagnosis of spinal meningioma considerably more often in women (81%) than in men (19%). The average age of all patients was 65 years. Most meningiomas were located in the thoracic spine (82%) while the rest (18%) were located in the cervical spine. The most common symptoms were motor deficit (80%) and sensation disorders (70%). Of the symptomatic patients, 71% clinically improved, 27% showed no change and 2% worsened postoperatively. The mean follow-up was 32 months (range 1-204). During this period, there was a 5% tumor recurrence rate. However, when we analyzed a subgroup of nine patients who were monitored for more than 6 years, tumor recurrence was diagnosed in 44%, all of whom were women (mean age 51 years). Conclusion: Our results indicate that tumor recurrence after Simpson II resection could be significantly higher than previously thought if the follow-up is long enough, especially in younger patients. This finding suggests we consider using radical Simpson grade I resection more frequently. The study also demonstrates that after spinal meningioma surgery the patients should be followed and monitored on a long-term basis.

Název v anglickém jazyce

Spinal meningiomas: is Simpson grade II resection radical enough?

Popis výsledku anglicky

Background: The optimal treatment for spinal meningioma is complete resection. The radicality of resection is the most important predictive factor for future tumor recurrence. Although clinical series dedicated to spinal meningiomas are relatively frequent, only a minimum of these defines the length of the required follow-up and difference in tumor recurrence in the context of Simpson grade I and II resection. Therefore, we propose reconsideration of surgical treatment and long-term follow-up based on a retrospective analysis of 84 patients who underwent Simpson grade II resection. Methods: The study included 84 patients operated between 1998 and 2018. Clinical symptomatology, age, sex, risk of comorbidities, spinal level, duration of symptoms, surgical resection radicality, tumor recurrence, and complications associated with treatment were recorded and evaluated. Results: We encountered the diagnosis of spinal meningioma considerably more often in women (81%) than in men (19%). The average age of all patients was 65 years. Most meningiomas were located in the thoracic spine (82%) while the rest (18%) were located in the cervical spine. The most common symptoms were motor deficit (80%) and sensation disorders (70%). Of the symptomatic patients, 71% clinically improved, 27% showed no change and 2% worsened postoperatively. The mean follow-up was 32 months (range 1-204). During this period, there was a 5% tumor recurrence rate. However, when we analyzed a subgroup of nine patients who were monitored for more than 6 years, tumor recurrence was diagnosed in 44%, all of whom were women (mean age 51 years). Conclusion: Our results indicate that tumor recurrence after Simpson II resection could be significantly higher than previously thought if the follow-up is long enough, especially in younger patients. This finding suggests we consider using radical Simpson grade I resection more frequently. The study also demonstrates that after spinal meningioma surgery the patients should be followed and monitored on a long-term basis.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

<a href="/cs/project/NV19-04-00272" target="_blank" >NV19-04-00272: Vztah origa meningiomu k arachnoidálním membránám, rozsahu resekce a chirurgickým rizikům</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Acta Neurochirurgica

ISSN

0001-6268

e-ISSN

—

Svazek periodika

162

Číslo periodika v rámci svazku

6

Stát vydavatele periodika

AT - Rakouská republika

Počet stran výsledku

8

Strana od-do

1401-1408

Kód UT WoS článku

000535383400029

EID výsledku v databázi Scopus

2-s2.0-85081937028