Felistia Yuli, Amanda Nadira Fildza, Hendrawan Fandi, Susanto Nugroho Harry, Al Fauzi Asra, Miftahussurur Muhammad
Doctoral Program of Medical Science, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Department of Neurology, National Brain Center Hospital, Jakarta, Indonesia.
Surg Neurol Int. 2025 Apr 25;16:149. doi: 10.25259/SNI_32_2025. eCollection 2025.
The objective of this study was to evaluate the outcomes of meningioma patients with the World Health Organization (WHO) grades I-III who underwent surgical resection and identify factors influencing recurrence and survival.
This retrospective study included patients who underwent surgery for meningioma at the National Brain Center Hospital between January 2020 and December 2022. Clinical characteristics of patients with recurrence, such as gender, age, preoperative Karnofsky Performance Scale (KPS), grading, and history of radiotherapy, were recorded. The recurrence time was assessed within 2 years post-surgery. Magnetic resonance imaging or computed tomography imaging results were used to determine meningioma location, while the WHO grading was based on pathological findings. Survival analysis of recurrence across different grades was performed using Kaplan-Meier curves.
Of the 184 patients who had surgical resection for meningioma, 53 (28.8%) experienced recurrence. The recurrence group consisted primarily of women (81%), with a preoperative KPS > 70% (83%), Simpson grading II-III (60.3%), WHO grade II (39.6%), and meningiomas located in the convexity (24.5%). Most patients (81.1%) had no history of radiotherapy, and 64.15% had two or more resections. The average recurrence-free period after surgery was 17.95 ± 20.39 months. Mortality due to recurrence was most common in the WHO grade II patients (11.1%). Kaplan-Meier curves showed differences in recurrence between grading subgroups, with the WHO grade III meningiomas exhibiting the highest recurrence rate and the worst prognosis.
Higher-grade meningiomas are more likely to recur and result in poorer outcomes. Further research is needed to investigate tumor recurrence at the molecular level. A multidisciplinary approach to treatment improves outcomes and reduces complications associated with recurrence.
本研究的目的是评估接受手术切除的世界卫生组织（WHO）I - III级脑膜瘤患者的治疗结果，并确定影响复发和生存的因素。
这项回顾性研究纳入了2020年1月至2022年12月期间在国家脑中心医院接受脑膜瘤手术的患者。记录复发患者的临床特征，如性别、年龄、术前卡诺夫斯基功能状态评分（KPS）、分级和放疗史。在术后2年内评估复发时间。使用磁共振成像或计算机断层扫描成像结果确定脑膜瘤位置，而WHO分级基于病理结果。使用Kaplan - Meier曲线对不同分级的复发进行生存分析。
在184例接受脑膜瘤手术切除的患者中，53例（28.8%）出现复发。复发组主要为女性（81%），术前KPS>70%（83%），辛普森分级为II - III级（60.3%），WHO II级（39.6%），脑膜瘤位于凸面（24.5%）。大多数患者（81.1%）无放疗史，64.15%接受过两次或更多次切除。术后平均无复发生存期为17.95±20.39个月。复发导致的死亡在WHO II级患者中最为常见（11.1%）。Kaplan - Meier曲线显示不同分级亚组之间的复发存在差异，WHO III级脑膜瘤的复发率最高，预后最差。
高级别脑膜瘤更易复发，预后更差。需要进一步研究从分子水平探究肿瘤复发情况。多学科治疗方法可改善治疗结果并减少与复发相关的并发症。
