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21.11.2023 | Original Article

Predictors of recurrence after surgical resection of parafalcine and parasagittal meningiomas

verfasst von: Omaditya Khanna, Adam Barsouk, Arbaz A. Momin, Aria Mahtabfar, Carrie E. Andrews, Karim Hafazalla, Matthews Lan, Pious D. Patel, Michael P. Baldassari, David W. Andrews, James J. Evans, Christopher J. Farrell, Kevin D. Judy

Erschienen in: Acta Neurochirurgica | Ausgabe 12/2023

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Abstract

Purpose

Owing to their vicinity near the superior sagittal sinus, parasagittal and parafalcine meningiomas are challenging tumors to surgically resect. In this study, we investigate key factors that portend increased risk of recurrence after surgery.

Methods

This is a retrospective study of patients who underwent resection of parasagittal and parafalcine meningiomas at our institution between 2012 and 2018. Relevant clinical, radiographic, and histopathological variables were selected for analysis as predictors of tumor recurrence.

Results

A total of 110 consecutive subjects (mean age: 59.4 ± 15.2 years, 67.3% female) with 74 parasagittal and 36 parafalcine meningiomas (92 WHO grade 1, 18 WHO grade 2/3), are included in the study. A total of 37 patients (33.6%) exhibited recurrence with median follow-up of 42 months (IQR: 10–71). In the overall cohort, parasagittal meningiomas exhibited shorter progression-free survival compared to parafalcine meningiomas (Kaplan–Meier log-rank p = 0.045). On univariate analysis, predictors of recurrence include WHO grade 2/3 vs. grade 1 tumors (p < 0.001), higher Ki-67 indices (p < 0.001), partial (p = 0.04) or complete sinus invasion (p < 0.001), and subtotal resection (p < 0.001). Multivariable Cox regression analysis revealed high-grade meningiomas (HR: 3.62, 95% CI: 1.60–8.22; p = 0.002), complete sinus invasion (HR: 3.00, 95% CI: 1.16–7.79; p = 0.024), and subtotal resection (HR: 3.10, 95% CI: 1.38–6.96; p = 0.006) as independent factors that portend shorter time to recurrence.

Conclusion

This study identifies several pertinent factors that confer increased risk of recurrence after resection of parasagittal and parafalcine meningiomas, which can be used to devise appropriate surgical strategy to achieve improved patient outcomes.

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Titel: Predictors of recurrence after surgical resection of parafalcine and parasagittal meningiomas
verfasst von: Omaditya Khanna
Adam Barsouk
Arbaz A. Momin
Aria Mahtabfar
Carrie E. Andrews
Karim Hafazalla
Matthews Lan
Pious D. Patel
Michael P. Baldassari
David W. Andrews
James J. Evans
Christopher J. Farrell
Kevin D. Judy
Publikationsdatum: 21.11.2023
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 12/2023
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05848-4

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Predictors of recurrence after surgical resection of parafalcine and parasagittal meningiomas