Brodbelt Andrew R, Barclay Matthew E, Greenberg David, Williams Matthew, Jenkinson Michael D, Karabatsou Konstantina
Department of Neurosurgery, The Walton Centre NHS Foundation trust, Liverpool, UK.
Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Br J Neurosurg. 2019 Dec;33(6):641-647. doi: 10.1080/02688697.2019.1661965. Epub 2019 Sep 17.
Meningiomas are the commonest predominantly non-malignant brain tumour in adults. The use of surgery appears to be increasing, and outcomes are thought to be good, but whole nation data for England is scarce. The aim of this report is to examine the epidemiology of patients operated for cranial and spinal meningioma in England, and to assess associations between outcomes and gender, age, meningioma site (cranial or spinal), and grade. A search strategy encompassing all patients coded with cranial and spinal meningioma treated between January 1999 and December 2013 was obtained from data linkage between the National Cancer Registration and Analysis Service and Hospital Episode Statistics for England. 25,694 patients were diagnosed with meningioma in England between 1999 and 2013, in whom 24,302 were cranial and 1392 spinal. Of these patients, 14,229 (60%) cranial and 1188 (85%) spinal meningioma received surgery. Of those operated on 70.1% were women, and, where the tumour grade was recorded, 79.5% were WHO grade I, 18.4% grade II, and 2.1% grade III. Five and ten year net survival rates for surgically treated cranial meningiomas were respectively 90% and 81% for those with WHO grade I, 80% and 63% for grade II, and 30% and 15% for WHO grade III tumours. Overall survival after surgery is better in women, younger adults, and people with spinal or lower grade meningiomas. Outcomes have improved over the time period examined. The outcome for patients with meningioma is good and is improving. However, there remains a significant mortality related to the disease process.
脑膜瘤是成人中最常见的主要为非恶性的脑肿瘤。手术的使用似乎在增加，且认为预后良好，但英格兰的全国性数据稀缺。本报告的目的是研究英格兰接受颅部和脊髓脑膜瘤手术患者的流行病学情况，并评估预后与性别、年龄、脑膜瘤部位（颅部或脊髓）及分级之间的关联。通过将国家癌症登记与分析服务中心和英格兰医院事件统计数据进行数据链接，获得了一个涵盖1999年1月至2013年12月期间所有编码为颅部和脊髓脑膜瘤患者的检索策略。1999年至2013年期间，英格兰有25694例患者被诊断为脑膜瘤，其中24302例为颅部脑膜瘤，1392例为脊髓脑膜瘤。在这些患者中，14229例（60%）颅部脑膜瘤和1188例（85%）脊髓脑膜瘤接受了手术。接受手术的患者中70.1%为女性，在记录了肿瘤分级的患者中，79.5%为世界卫生组织（WHO）I级，18.4%为II级，2.1%为III级。手术治疗的颅部脑膜瘤患者中，WHO I级患者的5年和10年净生存率分别为90%和81%，II级患者为80%和63%，WHO III级肿瘤患者为30%和15%。女性、年轻成年人以及患有脊髓脑膜瘤或低级别脑膜瘤的患者术后总体生存率更高。在所研究的时间段内，预后有所改善。脑膜瘤患者的预后良好且正在改善。然而，与疾病过程相关的死亡率仍然很高。
