Department of Neurosciences, Nepal Mediciti Hospital, Sainbu, Lalitpur, Nepal.
Department of Neurosciences, Nepal Mediciti Hospital, Sainbu, Lalitpur, Nepal.
World Neurosurg. 2021 Apr;148:e138-e144. doi: 10.1016/j.wneu.2020.12.079. Epub 2020 Dec 24.
Meningioma is the most common primary brain tumor, constituting more than half of all benign central nervous system tumors. This study aims to analyze the clinical outcome and recurrence after surgery of intracranial meningioma in Nepal.
This is a retrospective study of newly diagnosed intracranial meningioma patients operated at Nepal Mediciti Hospital between 2007 and 2019. Demographics; clinical, radiologic, and perioperative details; histopathology; and clinical outcome variables were reviewed. Association of independent variables with primary outcome variables: modified Rankin Scale (favorable [≤ 3] vs. unfavorable [>3]) and recurrence was analyzed. Logistic regression model was designed to calculate adjusted odds ratio with 95% confidence interval (CI).
Of 233 patients, mean age was 47 years, female individuals were affected twice as much as male individuals. Location was supratentorial in 83.3%, 83.7% had tumor greater than 5 cm in size. Gross total resection (SM 0-III) was achieved in 85.4%. A total of 98.7% had grade I meningioma. Favorable outcome was found in 94.8%. Recurrence rate was 6.9%. Tumor size less than 3 cm (adjusted odds ratio [AOR] 0.024 95% CI 0.001-0.416, P = 0.010), gross total resection (AOR 19.737, 95% CI 4.69-83.063, P < 0.001), and comorbidity (AOR 0.202, 95% CI 0.052-0.785, P = 0.021) were significantly associated with favorable outcome whereas age (AOR 3.491, 95% CI 1.029-11.850, P = 0.045) and WHO grade (AOR 0.024, 95% CI 0.002-0.344, P = 0.006) were independently associated with recurrence. The complication and surgical mortality rates were 30% and 1.72%, respectively.
Tumor size, extent of resection, age, tumor grade, and medical comorbidities were significantly associated with postoperative outcome. We recommend a prospective study with standardized follow up protocol to assess the long-term outcome.
脑膜瘤是最常见的原发性脑肿瘤，占所有良性中枢神经系统肿瘤的一半以上。本研究旨在分析尼泊尔颅内脑膜瘤患者的手术临床结果和复发情况。
这是一项对 2007 年至 2019 年在尼泊尔 Mediciti 医院接受手术治疗的新发颅内脑膜瘤患者进行的回顾性研究。回顾了患者的人口统计学特征、临床、影像学和围手术期详细信息、组织病理学以及临床结局变量。分析了独立变量与主要结局变量（改良 Rankin 量表（良好[≤3]与不良[>3]）和复发）的相关性。设计了逻辑回归模型，以计算 95%置信区间（CI）的调整后优势比。
在 233 例患者中，平均年龄为 47 岁，女性患者是男性患者的两倍。83.3%的肿瘤位于幕上，83.7%的肿瘤大于 5cm。实现了 85.4%的大体全切除（SM 0-III）。98.7%的患者为 I 级脑膜瘤。良好的结局发生率为 94.8%。复发率为 6.9%。肿瘤大小小于 3cm（调整后的优势比[OR]0.024，95%CI0.001-0.416，P=0.010）、大体全切除（OR19.737，95%CI4.69-83.063，P<0.001）和合并症（OR0.202，95%CI0.052-0.785，P=0.021）与良好的结局显著相关，而年龄（OR3.491，95%CI1.029-11.850，P=0.045）和 WHO 分级（OR0.024，95%CI0.002-0.344，P=0.006）与复发独立相关。并发症和手术死亡率分别为 30%和 1.72%。
肿瘤大小、切除范围、年龄、肿瘤分级和合并症与术后结局显著相关。我们建议进行一项前瞻性研究，制定标准化的随访方案，以评估长期结果。
