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Meningioma Surgery-Are We Making Progress?

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Meling, TR, Da Broi, M, Scheie, D, Helseth, E & Smoll, NR 2019, 'Meningioma Surgery-Are We Making Progress?', World Neurosurgery, bind 125, s. e205-e213. https://doi.org/10.1016/j.wneu.2019.01.042

APA

Meling, T. R., Da Broi, M., Scheie, D., Helseth, E., & Smoll, N. R. (2019). Meningioma Surgery-Are We Making Progress? World Neurosurgery, 125, e205-e213. https://doi.org/10.1016/j.wneu.2019.01.042

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MLA

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Author

Meling, Torstein R ; Da Broi, Michele ; Scheie, David ; Helseth, Eirik ; Smoll, Nicolas R. / Meningioma Surgery-Are We Making Progress?. I: World Neurosurgery. 2019 ; Bind 125. s. e205-e213.

Bibtex

@article{ada3105b383c400997c1b77a42deb2f3,
title = "Meningioma Surgery-Are We Making Progress?",
abstract = "BACKGROUND: To study improvements in outcomes after surgery for intracranial meningiomas.METHODS: We performed a longitudinal observational study comparing 1469 patients operated on for intracranial meningioma in 4 consecutive time frames (1990-1994, 1995-1999, 2000-2004, and 2005-2010).RESULTS: Median age at surgery was 58.3 years. Median follow-up was 7 years. Patients in later periods were older than in the earlier ones (odds ratio [OR], 1.19 [1.09-1.32]; P < 0.0005), indicating a trend toward operating on more elderly patients. Before 2000, 42%, 32%, 6%, 19%, and 0.3% achieved Simpson grade (SG) I, II, III, IV, and V, respectively, whereas the SG rates were 35%, 37%, 4%, 23%, and 0.9% after 2000 (OR, 1.18 [1.06-1.30]; P < 0.005). The perioperative mortality (OR, 0.65 [0.46-0.91]; P < 0.05) and worsened neurologic outcome rate (OR, 0.70 [0.60-0.83]; P < 0.0001) were significantly lower in later decades, but the 4 surgical periods were similar regarding postoperative infections and hematomas. Retreatment-free survival (RFS) and overall survival (OS) increased significantly over the 4 time frames (P < 0.05 and P < 0.0001, respectively). Multivariate analysis confirmed the improvement of surgical radicality, neurologic outcome, perioperative mortality, OS, and RFS.CONCLUSIONS: Meningioma surgery as well as patient population changed over the 2 decades considered in this study. We observed higher rates of gross total resection in the later period and the perioperative outcomes improved or were unchanged, which signifies better long-term outcomes, RFS, and OS.",
keywords = "Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Craniotomy/mortality, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Meningeal Neoplasms/surgery, Meningioma/mortality, Middle Aged, Postoperative Complications/etiology, Quality of Health Care, Reoperation/statistics & numerical data, Retreatment/statistics & numerical data, Skull Base Neoplasms/mortality, Time Factors, Treatment Outcome, Young Adult",
author = "Meling, {Torstein R} and {Da Broi}, Michele and David Scheie and Eirik Helseth and Smoll, {Nicolas R}",
note = "Copyright {\textcopyright} 2019 Elsevier Inc. All rights reserved.",
year = "2019",
month = may,
doi = "10.1016/j.wneu.2019.01.042",
language = "English",
volume = "125",
pages = "e205--e213",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc",

}

RIS

TY - JOUR

T1 - Meningioma Surgery-Are We Making Progress?

AU - Meling, Torstein R

AU - Da Broi, Michele

AU - Scheie, David

AU - Helseth, Eirik

AU - Smoll, Nicolas R

N1 - Copyright © 2019 Elsevier Inc. All rights reserved.

PY - 2019/5

Y1 - 2019/5

N2 - BACKGROUND: To study improvements in outcomes after surgery for intracranial meningiomas.METHODS: We performed a longitudinal observational study comparing 1469 patients operated on for intracranial meningioma in 4 consecutive time frames (1990-1994, 1995-1999, 2000-2004, and 2005-2010).RESULTS: Median age at surgery was 58.3 years. Median follow-up was 7 years. Patients in later periods were older than in the earlier ones (odds ratio [OR], 1.19 [1.09-1.32]; P < 0.0005), indicating a trend toward operating on more elderly patients. Before 2000, 42%, 32%, 6%, 19%, and 0.3% achieved Simpson grade (SG) I, II, III, IV, and V, respectively, whereas the SG rates were 35%, 37%, 4%, 23%, and 0.9% after 2000 (OR, 1.18 [1.06-1.30]; P < 0.005). The perioperative mortality (OR, 0.65 [0.46-0.91]; P < 0.05) and worsened neurologic outcome rate (OR, 0.70 [0.60-0.83]; P < 0.0001) were significantly lower in later decades, but the 4 surgical periods were similar regarding postoperative infections and hematomas. Retreatment-free survival (RFS) and overall survival (OS) increased significantly over the 4 time frames (P < 0.05 and P < 0.0001, respectively). Multivariate analysis confirmed the improvement of surgical radicality, neurologic outcome, perioperative mortality, OS, and RFS.CONCLUSIONS: Meningioma surgery as well as patient population changed over the 2 decades considered in this study. We observed higher rates of gross total resection in the later period and the perioperative outcomes improved or were unchanged, which signifies better long-term outcomes, RFS, and OS.

AB - BACKGROUND: To study improvements in outcomes after surgery for intracranial meningiomas.METHODS: We performed a longitudinal observational study comparing 1469 patients operated on for intracranial meningioma in 4 consecutive time frames (1990-1994, 1995-1999, 2000-2004, and 2005-2010).RESULTS: Median age at surgery was 58.3 years. Median follow-up was 7 years. Patients in later periods were older than in the earlier ones (odds ratio [OR], 1.19 [1.09-1.32]; P < 0.0005), indicating a trend toward operating on more elderly patients. Before 2000, 42%, 32%, 6%, 19%, and 0.3% achieved Simpson grade (SG) I, II, III, IV, and V, respectively, whereas the SG rates were 35%, 37%, 4%, 23%, and 0.9% after 2000 (OR, 1.18 [1.06-1.30]; P < 0.005). The perioperative mortality (OR, 0.65 [0.46-0.91]; P < 0.05) and worsened neurologic outcome rate (OR, 0.70 [0.60-0.83]; P < 0.0001) were significantly lower in later decades, but the 4 surgical periods were similar regarding postoperative infections and hematomas. Retreatment-free survival (RFS) and overall survival (OS) increased significantly over the 4 time frames (P < 0.05 and P < 0.0001, respectively). Multivariate analysis confirmed the improvement of surgical radicality, neurologic outcome, perioperative mortality, OS, and RFS.CONCLUSIONS: Meningioma surgery as well as patient population changed over the 2 decades considered in this study. We observed higher rates of gross total resection in the later period and the perioperative outcomes improved or were unchanged, which signifies better long-term outcomes, RFS, and OS.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Craniotomy/mortality

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Longitudinal Studies

KW - Male

KW - Meningeal Neoplasms/surgery

KW - Meningioma/mortality

KW - Middle Aged

KW - Postoperative Complications/etiology

KW - Quality of Health Care

KW - Reoperation/statistics & numerical data

KW - Retreatment/statistics & numerical data

KW - Skull Base Neoplasms/mortality

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1016/j.wneu.2019.01.042

DO - 10.1016/j.wneu.2019.01.042

M3 - Journal article

C2 - 30684722

VL - 125

SP - e205-e213

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -

ID: 59040451