Qasem Lina-Elisabeth, Soydas Dilara, Al-Hilou Ali, Oros Jan, Weber Katharina J, Keil Fee, Jussen Daniel, Prinz Vincent, Seifert Volker, Baumgarten Peter, Marquardt Gerhard, Czabanka Marcus
Goethe University Frankfurt, University Hospital, Center for Neurology and Neurosurgery, Department of Neurosurgery, Frankfurt am Main, Germany.
Goethe University Frankfurt, University Hospital, Neurological Institute (Edinger Institute), Department of Neuropathology, Frankfurt am Main, Germany.
Brain Spine. 2025 May 31;5:104290. doi: 10.1016/j.bas.2025.104290. eCollection 2025.
Surgical resection is the primary treatment for symptomatic anterior midline skull base meningiomas.
This study evaluates the impact of tumor size and peritumoral edema on clinical outcome.
A retrospective analysis of 109 patients who underwent resection between 2012 and 2022 was conducted. Tumors were categorized as: size 1 (<30 mm), size 2 (30-50 mm), and size 3 (>50 mm). Peritumoral edema was classified as: type 1 (no edema), type 2 (edema diameter < tumor diameter), and type 3 (edema diameter > tumor diameter). Clinical outcomes were assessed using the Karnofsky Performance Scale (KPS) at discharge, three months postoperatively, and at last follow-up. Additionally, complication rates were analyzed.
Patients with size 3 tumors had significantly worse KPS scores at discharge (50 %) than those with size 2 (70 %) or size 1 tumors (80 %; p < 0.0001). At three months, KPS differences remained significant (p = 0.0209). For size 3 tumors, KPS at discharge was significantly associated with edema: 90 % for no edema, 70 % for type 2 edema, and 50 % for type 3 edema (p = 0.0008). Complication rates were higher in size 2 and 3 tumors (35-37 %) compared to size 1 (14 %; p = 0.0330). Tumors with peritumoral edema had increased complication rates (35 %) versus those without (23 %; p = 0.2051).
The combination of large tumor size and extensive peritumoral edema are associated with reduced early postoperative outcomes and higher complication rates. These findings underscore the importance of careful preoperative patient selection and tailored surgical strategies to optimize patient outcomes.
手术切除是有症状的前颅底中线脑膜瘤的主要治疗方法。
本研究评估肿瘤大小和瘤周水肿对临床结局的影响。
对2012年至2022年间接受手术切除的109例患者进行回顾性分析。肿瘤分为：1型（<30毫米）、2型（30 - 50毫米）和3型（>50毫米）。瘤周水肿分为：1型（无水肿）、2型（水肿直径<肿瘤直径）和3型（水肿直径>肿瘤直径）。使用卡氏功能状态量表（KPS）在出院时、术后三个月及末次随访时评估临床结局。此外，分析并发症发生率。
3型肿瘤患者出院时的KPS评分（50%）明显低于2型（70%）或1型肿瘤患者（80%；p<0.0001）。三个月时，KPS差异仍显著（p = 0.0209）。对于3型肿瘤，出院时的KPS与水肿显著相关：无水肿者为90%，2型水肿者为70%，3型水肿者为50%（p = 0.0008）。2型和3型肿瘤的并发症发生率（分别为35% - 37%）高于1型（14%；p = 0.0330）。有瘤周水肿的肿瘤并发症发生率（35%）高于无水肿者（23%；p = 0.2051）。
肿瘤体积大与广泛的瘤周水肿共同导致术后早期结局较差和并发症发生率较高。这些发现强调了术前仔细选择患者和制定个性化手术策略以优化患者结局的重要性。
