Escribano Mesa José Alberto, Alonso Morillejo Enrique, Parrón Carreño Tesifón, Huete Allut Antonio, Narro Donate José María, Méndez Román Paddy, Contreras Jiménez Ascensión, Pedrero García Francisco, Masegosa González José
Department of Neurosurgery, Complejo Hospitalario Torrecárdenas, Almería, Spain.
Department of Psychology, University of Almería, Almería, Spain.
World Neurosurg. 2018 Feb;110:e112-e118. doi: 10.1016/j.wneu.2017.10.087. Epub 2017 Oct 26.
Parasagittal meningiomas arise from the arachnoid cells of the angle formed between the superior sagittal sinus (SSS) and the brain convexity. In this retrospective study, we focused on factors that predict early recurrence and recurrence times.
We reviewed 125 patients with parasagittal meningiomas operated from 1985 to 2014. We studied the following variables: age, sex, location, laterality, histology, surgeons, invasion of the SSS, Simpson removal grade, follow-up time, angiography, embolization, radiotherapy, recurrence and recurrence time, reoperation, neurologic deficit, degree of dependency, and patient status at the end of follow-up.
Patients ranged in age from 26 to 81 years (mean 57.86 years; median 60 years). There were 44 men (35.2%) and 81 women (64.8%). There were 57 patients with neurologic deficits (45.2%). The most common presenting symptom was motor deficit. World Health Organization grade I tumors were identified in 104 patients (84.6%), and the majority were the meningothelial type. Recurrence was detected in 34 cases. Time of recurrence was 9 to 336 months (mean: 84.4 months; median: 79.5 months). Male sex was identified as an independent risk for recurrence with relative risk 2.7 (95% confidence interval 1.21-6.15), P = 0.014. Kaplan-Meier curves for recurrence had statistically significant differences depending on sex, age, histologic type, and World Health Organization histologic grade. A binary logistic regression was made with the Hosmer-Lemeshow test with P > 0.05; sex, tumor size, and histologic type were used in this model.
Male sex is an independent risk factor for recurrence that, associated with other factors such tumor size and histologic type, explains 74.5% of all cases in a binary regression model.
矢状窦旁脑膜瘤起源于上矢状窦（SSS）与脑凸面之间夹角处的蛛网膜细胞。在这项回顾性研究中，我们重点关注预测早期复发和复发时间的因素。
我们回顾了1985年至2014年接受手术治疗的125例矢状窦旁脑膜瘤患者。我们研究了以下变量：年龄、性别位置、侧别、组织学类型、手术医生、矢状窦侵犯情况、辛普森切除分级、随访时间、血管造影、栓塞、放疗、复发及复发时间、再次手术、神经功能缺损、依赖程度以及随访结束时的患者状态。
患者年龄在26岁至81岁之间（平均57.86岁；中位数60岁）。男性44例（35.2%），女性81例（64.8%）。有57例患者存在神经功能缺损（45.2%）。最常见的首发症状是运动功能缺损。104例患者（84.6%）被诊断为世界卫生组织I级肿瘤，且大多数为脑膜内皮型。34例患者出现复发。复发时间为9至336个月（平均：84.4个月；中位数：79.5个月）。男性被确定为复发的独立危险因素，相对危险度为2.7（95%置信区间1.21 - 6.15），P = 0.014。复发的Kaplan - Meier曲线在性别、年龄、组织学类型和世界卫生组织组织学分级方面存在统计学显著差异。使用Hosmer - Lemeshow检验进行二元逻辑回归，P > 0.05；该模型中使用了性别、肿瘤大小和组织学类型。
男性是复发的独立危险因素，与肿瘤大小和组织学类型等其他因素相关，在二元回归模型中可解释所有病例的74.5%。
