Long-term surgical outcomes of spinal meningiomas

Masaya Nakamura, Osahiko Tsuji, Kanehiro Fujiyoshi, Naobumi Hosogane, Kota Watanabe, Takashi Tsuji, Ken Ishii, Yoshiaki Toyama, Kazuhiro Chiba, Morio Matsumoto

Research output: Contribution to journalArticle

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Abstract

STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7%, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29%) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47%) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10% for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30% of patients who underwent grade II resection.

Original languageEnglish
JournalSpine
Volume37
Issue number10
DOIs
Publication statusPublished - 01-05-2012
Externally publishedYes

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Meningioma
Recurrence
Neoplasms
Dura Mater
Reoperation
Magnetic Resonance Spectroscopy

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Nakamura, M., Tsuji, O., Fujiyoshi, K., Hosogane, N., Watanabe, K., Tsuji, T., ... Matsumoto, M. (2012). Long-term surgical outcomes of spinal meningiomas. Spine, 37(10). https://doi.org/10.1097/BRS.0b013e31824167f1
Nakamura, Masaya ; Tsuji, Osahiko ; Fujiyoshi, Kanehiro ; Hosogane, Naobumi ; Watanabe, Kota ; Tsuji, Takashi ; Ishii, Ken ; Toyama, Yoshiaki ; Chiba, Kazuhiro ; Matsumoto, Morio. / Long-term surgical outcomes of spinal meningiomas. In: Spine. 2012 ; Vol. 37, No. 10.
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abstract = "STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7{\%}, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29{\%}) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47{\%}) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10{\%} for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30{\%} of patients who underwent grade II resection.",
author = "Masaya Nakamura and Osahiko Tsuji and Kanehiro Fujiyoshi and Naobumi Hosogane and Kota Watanabe and Takashi Tsuji and Ken Ishii and Yoshiaki Toyama and Kazuhiro Chiba and Morio Matsumoto",
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Nakamura, M, Tsuji, O, Fujiyoshi, K, Hosogane, N, Watanabe, K, Tsuji, T, Ishii, K, Toyama, Y, Chiba, K & Matsumoto, M 2012, 'Long-term surgical outcomes of spinal meningiomas', Spine, vol. 37, no. 10. https://doi.org/10.1097/BRS.0b013e31824167f1

Long-term surgical outcomes of spinal meningiomas. / Nakamura, Masaya; Tsuji, Osahiko; Fujiyoshi, Kanehiro; Hosogane, Naobumi; Watanabe, Kota; Tsuji, Takashi; Ishii, Ken; Toyama, Yoshiaki; Chiba, Kazuhiro; Matsumoto, Morio.

In: Spine, Vol. 37, No. 10, 01.05.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term surgical outcomes of spinal meningiomas

AU - Nakamura, Masaya

AU - Tsuji, Osahiko

AU - Fujiyoshi, Kanehiro

AU - Hosogane, Naobumi

AU - Watanabe, Kota

AU - Tsuji, Takashi

AU - Ishii, Ken

AU - Toyama, Yoshiaki

AU - Chiba, Kazuhiro

AU - Matsumoto, Morio

PY - 2012/5/1

Y1 - 2012/5/1

N2 - STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7%, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29%) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47%) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10% for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30% of patients who underwent grade II resection.

AB - STUDY DESIGN.: Retrospective case series. OBJECTIVE.: To evaluate the treatment strategies for spinal meningioma. SUMMARY OF BACKGROUND DATA.: Although previous studies have demonstrated favorable surgical outcomes for spinal meningioma, with a low incidence of tumor recurrence, few have examined long-term surgical outcomes. METHODS.: The influence of patient age, surgical margin status (Simpson grade), tumor location, and histological subtype on tumor recurrence were examined retrospectively. In addition, the resected dura mater from Simpson grade I cases was examined for invasive tumor cells and compared with the presence or absence of a dural tail sign on magnetic resonance image. RESULTS.: Complete resection (Simpson grades I and II) was performed in 62 patients. Among them, the tumor recurrence rate was 9.7%, all in patients who underwent grade II resection for ventral spinal lesions. The mean duration to reoperation in these patients was 12.2 ± 5.2 years. Of the 6 patients who underwent incomplete resection (Simpson grade III/IV), all required reoperation for tumor recurrence or regrowth, 5 years later on average. Patients younger than 50 years at the initial surgery had a significantly higher recurrence rate than those aged 50 years or older. Histologic examination of 43 dura mater specimens from Simpson grade I-resection patients revealed tumor cell invasion between the inner and outer layers in 15 patients. This invasion was noted in 8 (29%) of 28 patients who were negative for the dural tail sign on magnetic resonance image, and in 7 (47%) of 15 patients who showed a positive dural tail sign. The MIB-1 index reached about 10% for dumbbell-type meningiomas invading the vertebral body; these were associated with repeated recurrence and unfavorable prognosis. CONCLUSION.: Long-term follow-up after surgery for meningiomas indicated that Simpson grade I resection should be selected whenever practicable when treating younger patients or dumbbell-type meningiomas. Tumors recurred at 12 years, on average, in approximately 30% of patients who underwent grade II resection.

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Nakamura M, Tsuji O, Fujiyoshi K, Hosogane N, Watanabe K, Tsuji T et al. Long-term surgical outcomes of spinal meningiomas. Spine. 2012 May 1;37(10). https://doi.org/10.1097/BRS.0b013e31824167f1