Remedy outcomes of 17 sufferers with atypical spinal meningioma, together with four with metastases: A retrospective observational examine.
Backbone J. 2018 Jun 12;:
Authors: Noh SH, Kim KH, Shin DA, Park JY, Yi S, Kuh SU, Kim KN, Chin DK, Kim KS, Yoon DH, Cho YE
BACKGROUND CONTEXT: Due to the shortage of atypical spinal meningioma, there’s a lack of analysis on the sort of tumor or its related metastases.
PURPOSE: The purpose of this examine was to analyze the organic conduct of atypical spinal meningioma and establish its prognostic elements by reviewing surgical and scientific outcomes of sufferers with these tumors.
STUDY DESIGN/SETTING: A retrospective chart evaluate was carried out.
PATIENT SAMPLE: We retrospectively reviewed the info from all sufferers who underwent spinal wire tumor excision between 1994 and 2017. Seventeen sufferers have been pathologically confirmed to have atypical spinal meningioma.
OUTCOME MEASURES: We examined sufferers’ neurologic standing by figuring out their Nurick scores earlier than and after surgical procedure. Furthermore, imaging research, laboratory information, and the employed surgical technique have been analyzed retrospectively, as was the Ki-67 index and prognosis following postoperative radiation remedy.
METHODS: The ranges, areas, and pathologic diagnoses of the tumors have been extracted from the radiological and pathological data of every affected person. The extent of surgical procedure and development of illness have been confirmed utilizing postoperative enhanced magnetic resonance imaging. Sufferers have been divided into 2 atypical spinal meningioma teams: major and metastatic. The demographics, age, intercourse, presenting symptom period, tumor location, Simpson resection grade, Ki-67, radiotherapy, recurrence, general survival, and progression-free survival of sufferers in each teams have been in contrast.
RESULTS: Seventeen sufferers have been included within the evaluation, of whom 12 (70%), four (24%), and 1 (6%) had tumors within the thoracic, cervical, and sacral areas, respectively. Full and subtotal resections have been achieved in 15 (88%) and a pair of (12%) sufferers, respectively. Total and progression-free survival charges in sufferers who underwent full resection have been longer than these in sufferers who underwent subtotal resection (P<zero.001). 4 sufferers (24%) had metastatic meningiomas within the mind, amongst whom three have been administered adjuvant radiotherapy after surgical procedure. Two affected person with intramedullary atypical spinal meningioma had metastatic tumors and skilled poorer prognoses. The 5-year general and progression-free survival charges have been 84.four% and 85.2%, respectively. The Simpson resection grade, Ki-67 index, and preoperative neurologic standing have been discovered to be essential prognostic elements on univariate Cox regression evaluation (P<zero.05).
CONCLUSIONS: Full resection ought to be thought of as a major therapy modality for people with atypical spinal meningioma. If subtotal resection is carried out, adjuvant remedy could be administered.
PMID: 29906618 [PubMed – as supplied by publisher]