Faculty of Medicine, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
Division of Neurosurgery, University of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada.
Acta Neurochir (Wien). 2023 Oct;165(10):2865-2871. doi: 10.1007/s00701-023-05758-5. Epub 2023 Aug 24.
Meningiomas can lead to significant morbidity and mortality and have recurrence potential. While previous studies have focused on calculating recurrence risk, the precise location of the recurrence has not been delineated. This study aimed to investigate the spatial clustering pattern of recurrence relative to the original surgical bed for surgically treated Simpson Grade I-III, WHO Grade 1 meningiomas.
Patients diagnosed with grade 1 meningiomas and treated with surgical resection with subsequent recurrence were reviewed. Patient demographics, clinical outcomes, and radiographic characteristics were collected. Radiological images were analyzed to determine the location of recurrence relative to the initial tumor. We characterized recurrence as type A (within the surgical bed), type B (outside of the surgical bed, within 1 cm from the site), and type C (distal ≥ 1 cm of the resection site).
Forty-two cases met the inclusion criteria. Twelve patients (29%) were male, and 30 (71%) were female. Median age at first treatment was 47 years, with 5.2 ± 3.4 years until recurrence. Recurrence rate was 54.7% at 5 years and 90.4% at 10 years. Twenty-eight patients (66.7%) had a type A recurrence, 11 (26.1%) had a type B recurrence, and 3 (7.1%) had a type C recurrence.
Our series demonstrates that while lesions often recur within the original lesion site, a significant portion recurs beyond the surgical bed. This highlights the substantial possibility of recurrence outside the resection cavity for fully excised benign meningiomas, which may aid in understanding disease progression and in guiding adjuvant therapy.
脑膜瘤可导致严重的发病率和死亡率，并具有复发的可能性。虽然之前的研究集中在计算复发风险上，但复发的确切位置尚未确定。本研究旨在调查相对于原始手术床的复发脑膜瘤的空间聚集模式，研究对象为接受手术治疗的 Simpson 分级 I-III 级、WHO 分级 1 级脑膜瘤患者。
回顾性分析经手术切除且随后复发的 1 级脑膜瘤患者的临床资料。收集患者的人口统计学、临床结局和影像学特征。对影像学图像进行分析，以确定复发相对于初始肿瘤的位置。我们将复发分为 A 型（在手术床内）、B 型（手术床外，距离肿瘤部位 1cm 以内）和 C 型（距离切除部位 1cm 以上）。
42 例符合纳入标准。12 例（29%）为男性，30 例（71%）为女性。首次治疗时的中位年龄为 47 岁，复发前的平均时间为 5.2±3.4 年。5 年和 10 年的复发率分别为 54.7%和 90.4%。28 例（66.7%）为 A 型复发，11 例（26.1%）为 B 型复发，3 例（7.1%）为 C 型复发。
本研究表明，尽管病变通常在原始病灶部位复发，但仍有相当一部分病变在手术床外复发。这突出表明，对于完全切除的良性脑膜瘤，切除腔外存在实质性复发的可能性，这可能有助于了解疾病进展并指导辅助治疗。
