Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas: Clinical article

Shigeo Oba, Masahito Kobayashi, Takashi Horiguchi, Satoshi Onozuka, Kazunari Yoshida, Takayuki Ohira, Takeshi Kawase

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Object. Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas, subtotal resection (STR) with or without radiation therapy can be considered as an alternative treatment for patients at considerable surgical risk. The long-term prognosis of such patients might be related to the biological activity of the tumor. This study examined predictors of progression-free survival (PFS) and sought to determine the optimal treatment strategies, focusing on the pathobiological findings of skull base meningiomas. Methods. This study included 281 patients with skull base meningiomas (mean follow-up period 88.4 months). Risk factors for tumor progression were examined using a multivariate analysis. The PFS and overall survival (OS) rates were evaluated using the Kaplan-Meier method. The functional outcomes of the patients were measured using the Karnofsky Performance Scale (KPS). Results. The 10-year PFS and OS rates were 66.4% and 97.4%, respectively. Overall, 83.3% of patients achieved a favorable outcome, that is, an improved or unchanged KPS score. The extent of resection, additional radiotherapy, histological grade, MIB-1 index, and p53-positive rate were significantly associated with PFS. The PFS of patients undergoing STR without radiation therapy was significantly shorter than that of either those undergoing STR with radiation therapy or GTR, while no statistical difference was observed between the latter 2 groups. Among the patients undergoing STR with pathobiological risk factors (histological grade, MIB-1 index, and p53-positive rate), the PFS of the patients who received radiation therapy was better than that of those who did not receive radiation therapy. Among the patients undergoing STR without such risk factors, the PFS was not significantly different between patients who received radiation therapy and those who did not. Conclusions. For patients with skull base meningiomas, a GTR is desirable and additional radiation therapy after STR may contribute to a longer PFS. Additional radiation therapy should be recommended, especially for patients with pathobiological risk factors, but not necessarily for those without such risks.

Original languageEnglish
Pages (from-to)1278-1287
Number of pages10
JournalJournal of Neurosurgery
Volume114
Issue number5
DOIs
Publication statusPublished - 01-05-2011

Fingerprint

Skull Base
Biological Factors
Meningioma
Disease-Free Survival
Radiotherapy
Karnofsky Performance Status
Survival Rate
Neoplasms
Therapeutics
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Oba, Shigeo ; Kobayashi, Masahito ; Horiguchi, Takashi ; Onozuka, Satoshi ; Yoshida, Kazunari ; Ohira, Takayuki ; Kawase, Takeshi. / Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas : Clinical article. In: Journal of Neurosurgery. 2011 ; Vol. 114, No. 5. pp. 1278-1287.
@article{a461e1112af7460bbc6736bfe20be126,
title = "Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas: Clinical article",
abstract = "Object. Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas, subtotal resection (STR) with or without radiation therapy can be considered as an alternative treatment for patients at considerable surgical risk. The long-term prognosis of such patients might be related to the biological activity of the tumor. This study examined predictors of progression-free survival (PFS) and sought to determine the optimal treatment strategies, focusing on the pathobiological findings of skull base meningiomas. Methods. This study included 281 patients with skull base meningiomas (mean follow-up period 88.4 months). Risk factors for tumor progression were examined using a multivariate analysis. The PFS and overall survival (OS) rates were evaluated using the Kaplan-Meier method. The functional outcomes of the patients were measured using the Karnofsky Performance Scale (KPS). Results. The 10-year PFS and OS rates were 66.4{\%} and 97.4{\%}, respectively. Overall, 83.3{\%} of patients achieved a favorable outcome, that is, an improved or unchanged KPS score. The extent of resection, additional radiotherapy, histological grade, MIB-1 index, and p53-positive rate were significantly associated with PFS. The PFS of patients undergoing STR without radiation therapy was significantly shorter than that of either those undergoing STR with radiation therapy or GTR, while no statistical difference was observed between the latter 2 groups. Among the patients undergoing STR with pathobiological risk factors (histological grade, MIB-1 index, and p53-positive rate), the PFS of the patients who received radiation therapy was better than that of those who did not receive radiation therapy. Among the patients undergoing STR without such risk factors, the PFS was not significantly different between patients who received radiation therapy and those who did not. Conclusions. For patients with skull base meningiomas, a GTR is desirable and additional radiation therapy after STR may contribute to a longer PFS. Additional radiation therapy should be recommended, especially for patients with pathobiological risk factors, but not necessarily for those without such risks.",
author = "Shigeo Oba and Masahito Kobayashi and Takashi Horiguchi and Satoshi Onozuka and Kazunari Yoshida and Takayuki Ohira and Takeshi Kawase",
year = "2011",
month = "5",
day = "1",
doi = "10.3171/2010.11.JNS10701",
language = "English",
volume = "114",
pages = "1278--1287",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "5",

}

Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas : Clinical article. / Oba, Shigeo; Kobayashi, Masahito; Horiguchi, Takashi; Onozuka, Satoshi; Yoshida, Kazunari; Ohira, Takayuki; Kawase, Takeshi.

In: Journal of Neurosurgery, Vol. 114, No. 5, 01.05.2011, p. 1278-1287.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term surgical outcome and biological prognostic factors in patients with skull base meningiomas

T2 - Clinical article

AU - Oba, Shigeo

AU - Kobayashi, Masahito

AU - Horiguchi, Takashi

AU - Onozuka, Satoshi

AU - Yoshida, Kazunari

AU - Ohira, Takayuki

AU - Kawase, Takeshi

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Object. Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas, subtotal resection (STR) with or without radiation therapy can be considered as an alternative treatment for patients at considerable surgical risk. The long-term prognosis of such patients might be related to the biological activity of the tumor. This study examined predictors of progression-free survival (PFS) and sought to determine the optimal treatment strategies, focusing on the pathobiological findings of skull base meningiomas. Methods. This study included 281 patients with skull base meningiomas (mean follow-up period 88.4 months). Risk factors for tumor progression were examined using a multivariate analysis. The PFS and overall survival (OS) rates were evaluated using the Kaplan-Meier method. The functional outcomes of the patients were measured using the Karnofsky Performance Scale (KPS). Results. The 10-year PFS and OS rates were 66.4% and 97.4%, respectively. Overall, 83.3% of patients achieved a favorable outcome, that is, an improved or unchanged KPS score. The extent of resection, additional radiotherapy, histological grade, MIB-1 index, and p53-positive rate were significantly associated with PFS. The PFS of patients undergoing STR without radiation therapy was significantly shorter than that of either those undergoing STR with radiation therapy or GTR, while no statistical difference was observed between the latter 2 groups. Among the patients undergoing STR with pathobiological risk factors (histological grade, MIB-1 index, and p53-positive rate), the PFS of the patients who received radiation therapy was better than that of those who did not receive radiation therapy. Among the patients undergoing STR without such risk factors, the PFS was not significantly different between patients who received radiation therapy and those who did not. Conclusions. For patients with skull base meningiomas, a GTR is desirable and additional radiation therapy after STR may contribute to a longer PFS. Additional radiation therapy should be recommended, especially for patients with pathobiological risk factors, but not necessarily for those without such risks.

AB - Object. Although gross-total resection (GTR) is a preferable treatment for skull base meningiomas, subtotal resection (STR) with or without radiation therapy can be considered as an alternative treatment for patients at considerable surgical risk. The long-term prognosis of such patients might be related to the biological activity of the tumor. This study examined predictors of progression-free survival (PFS) and sought to determine the optimal treatment strategies, focusing on the pathobiological findings of skull base meningiomas. Methods. This study included 281 patients with skull base meningiomas (mean follow-up period 88.4 months). Risk factors for tumor progression were examined using a multivariate analysis. The PFS and overall survival (OS) rates were evaluated using the Kaplan-Meier method. The functional outcomes of the patients were measured using the Karnofsky Performance Scale (KPS). Results. The 10-year PFS and OS rates were 66.4% and 97.4%, respectively. Overall, 83.3% of patients achieved a favorable outcome, that is, an improved or unchanged KPS score. The extent of resection, additional radiotherapy, histological grade, MIB-1 index, and p53-positive rate were significantly associated with PFS. The PFS of patients undergoing STR without radiation therapy was significantly shorter than that of either those undergoing STR with radiation therapy or GTR, while no statistical difference was observed between the latter 2 groups. Among the patients undergoing STR with pathobiological risk factors (histological grade, MIB-1 index, and p53-positive rate), the PFS of the patients who received radiation therapy was better than that of those who did not receive radiation therapy. Among the patients undergoing STR without such risk factors, the PFS was not significantly different between patients who received radiation therapy and those who did not. Conclusions. For patients with skull base meningiomas, a GTR is desirable and additional radiation therapy after STR may contribute to a longer PFS. Additional radiation therapy should be recommended, especially for patients with pathobiological risk factors, but not necessarily for those without such risks.

UR - http://www.scopus.com/inward/record.url?scp=79955653747&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955653747&partnerID=8YFLogxK

U2 - 10.3171/2010.11.JNS10701

DO - 10.3171/2010.11.JNS10701

M3 - Article

C2 - 21166572

AN - SCOPUS:79955653747

VL - 114

SP - 1278

EP - 1287

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 5

ER -