Authors:
Kotecha RS, Jacoby P, Cole CH, Gottardo NG
Authors notes:
Cancer. 2013:online
Keywords:
Adolescent, Child, Meningioma, Morbidity, Survivorship
Abstract:
The extent of initial surgical resection has been identified as the strongest prognostic indicator for survival in child and adolescent meningioma.
Given the paucity of data concerning long-term outcome, the authors undertook a meta-analysis to analyze morbidity in survivors of this disease.
Of 261 patients, 48% reported a completely normal life with no morbidity, and 25% had moderate/severe meningioma-associated morbidity at last follow-up.
Multivariate analysis identified relapse as the only independent variable associated with an increased risk of morbidity.
Univariate analysis also revealed an increased risk for patients with neurofibromatosis.
Subgroup analysis identified a higher incidence of morbidity among patients who had intracranial tumors with a skull base location compared with a nonskull base location.
Timing at which morbidity occurred was available for 70 patients, with persistence of preoperative tumor-related symptoms in 67% and as a result of therapy in 20%.
The majority of survivors of child and adolescent meningioma had no or only mild long-term morbidity, whereas 25% had moderate/severe morbidity, with a significantly increased risk in patients with relapsed disease.
In the majority, morbidity occurred as a consequence of the tumor itself, justifying aggressive surgery to achieve gross total resection.
However, for patients with neurofibromatosis and skull base meningioma, a more cautious surgical approach should be reserved.