J Korean Neurosurg Soc.  2014 Jun;55(6):321-330. 10.3340/jkns.2014.55.6.321.

Surgical Experience of Infratentorial Meningiomas : Clinical Series at a Single Institution during the 20-Year Period

• Jung MH
• Moon KS
• Lee KH
• Jang WY
• Jung TY
• Jung S

• KMID: 2191111
• DOI: http://doi.org/10.3340/jkns.2014.55.6.321

Abstract

OBJECTIVE
Based on surgical outcomes of patients with infratentorial meningiomas surgically treated at our institution, we analyzed the predictors for surgical resection, recurrence, complication, and survival.
METHODS
Of surgically treated 782 patients with intracranial meningioma, 158 (20.2%) consecutive cases of infratentorial location operated on between April 1993 and May 2013 at out institute were reviewed retrospectively. The patients had a median age of 57.1 years (range, 16--77 years), a female predominance of 79.7%, and a mean follow-up duration of 48.4 months (range, 0.8--242.2 months).
RESULTS
Gross total resection (Simpson's grade I & II) was achieved in 81.6% (129/158) of patients. Non-skull base location was an independent factor for complete resection. The recurrence rate was 13.3% (21/158) and the 5-, 10-, and 15-year recurrence rates were 8.2%, 12.0%, and 13.3%, respectively. Benign pathology, postoperative KPS over than 90, low peritumoral edema, and complete resection were significantly associated with longer recurrence-free survival rate. The 5-, 10-, and 15-year survival rates were 96.2%, 94.9%, and 94.9%, respectively. Benign pathology, postoperative KPS over than 90 and complete resection were significantly associated with a longer survival rate. The permanent complication rate was 13% (21/158). Skull base location and postoperative KPS less than 90 were independent factors for the occurrence of permanent complication.
CONCLUSION
Our experience shows that infratentorial meningiomas represent a continuing challenge for contemporary neurosurgeons. Various factors are related with resection degree, complications, recurrence and survival.

Keyword

Complication; Intracranial meningioma; Infratentorial; Recurrence; Surgical outcome; Survival

MeSH Terms

Edema
Female
Follow-Up Studies
Humans
Meningioma*
Pathology
Recurrence
Retrospective Studies
Skull Base
Survival Rate

Figure

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  Fig. 1 Overall recurrence-free survival. The incidence of recurrence rate is 13.3% (21/158) with the mean recurrence time of 149.7 months 95% confidence index : 128.3--171.2 months, the median recurrence time has not reached.

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  Fig. 2 Kaplan-Meier analysis of recurrence-free survival for enrolled patients according to independent predictors on multivariate analysis (overall comparison was estimated using a log-rank test). A : Peritumoral edema. B : Simpson's grade. C : Pathology. D : Postoperative Karnofsky performance scale.

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  Fig. 3 Overall survival. The incidence of death rate was 5.0% (8/158) with the mean survival time of 224.1 months 95% confidence index : 211.3-237.0 months, the median survival time was not reached.

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  Fig. 4 Kaplan-Meier analysis of overall survival for enrolled patients according to independent predictors on multivariate analysis (overall comparison was estimated using a log-rank test). A : Simpson's grade. B : Pathology. C : Postoperative Karnofsky performance scale.

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