Meling Torstein R, Da Broi Michele, Scheie David, Helseth Eirik
Faculty of Medicine, University of Oslo, N-0027, Oslo, Norway.
Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
Neurosurg Rev. 2019 Mar;42(1):163-173. doi: 10.1007/s10143-018-0976-7. Epub 2018 Apr 7.
To identify differences between skull base meningiomas (SBM) and non-skull base meningiomas (NSBM). All adult patients (18.0-69.9 years) operated for intracranial meningiomas between 1990 and 2010 at our institution were investigated. Al-Mefty's definition was used to dichotomize tumors into SBM and NSBM. Overall, 1148 consecutive patients were identified. Median age at surgery was 54.2 years [18.1-69.9]. Median follow-up was 7.4 years [0.0-20.9]. There were 562 patients (49%) with SBM and 586 (51%) with NSBM. The two groups were similar with respect to patient age, follow-up time, and number of patients. Overall female-to-male ratio was 2.6:1, but 3.2:1 in SBM and 2.2:1 in NSBM (p < 0.005). With respect to presenting symptoms, SBMs had more often neurological deficits (risk ratio (RR) 1.4; p < 0.0001) and less often seizures (RR 0.4; p < 0.0001). Gross total resections were less frequent in SBM than NSBM (62 vs 84%) (RR 1.3; p < 0.0001). SBMs had a lower risk of WHO grades II and III histology (4.5 vs 9.5%) (RR 0.5; p < 0.001). Worsening of neurological function was more frequent in SBM (21 vs 121%) (RR 1.8; p < 0.001). Retreatment-free survival at 5, 10, and 15 years, respectively, was 80, 70, and 62% for SBM versus 90, 82, and 74% for NSBM (p < 0.0001). Overall survival at 5, 10, and 15 years, respectively, was 93, 85, and 78% for SBM and 96, 91, and 79% for NSBM (p = 0.14). Patients with SBMs had more new-onset neurological deficits and significantly shorter retreatment-free survivals, but this did not adversely affect the overall survival.
为了鉴别颅底脑膜瘤（SBM）与非颅底脑膜瘤（NSBM）之间的差异。对1990年至2010年间在我们机构接受颅内脑膜瘤手术的所有成年患者（18.0 - 69.9岁）进行了调查。采用阿尔-梅夫蒂的定义将肿瘤分为SBM和NSBM。总体而言，共确定了1148例连续患者。手术时的中位年龄为54.2岁[18.1 - 69.9]。中位随访时间为7.4年[0.0 - 20.9]。有562例（49%）患者患有SBM，586例（51%）患有NSBM。两组在患者年龄、随访时间和患者数量方面相似。总体男女比例为2.6:1，但SBM组为3.2:1，NSBM组为2.2:1（p < 0.005）。就出现的症状而言，SBM更常出现神经功能缺损（风险比（RR）1.4；p < 0.0001），而癫痫发作较少见（RR 0.4；p < 0.0001）。SBM的全切率低于NSBM（62%对84%）（RR 1.3；p < 0.0001）。SBM的WHO II级和III级组织学风险较低（4.5%对9.5%）（RR 0.5；p < 0.001）。SBM中神经功能恶化更常见（21%对12%）（RR 1.8；p < 0.001）。SBM在5年、10年和15年时的无再治疗生存率分别为80%、70%和62%，而NSBM分别为90%、82%和74%（p < 0.0001）。SBM在5年、10年和15年时的总生存率分别为93%、85%和78%，NSBM分别为96%、91%和79%（p = 0.14）。患有SBM的患者有更多新发神经功能缺损且无再治疗生存期明显更短，但这并未对总生存产生不利影响。
