• Stylianos Pikis, Georgios Mantziaris, Adomas Bunevicius, Abdurrahman I Islim, Selcuk Peker, Yavuz Samanci, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, El-ShehabyAmr M NAMNGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt., Khaled Abdelkarim, Reem M Emad, Violaine Delabar, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, Roman Liscak, Jaromir May, Roberto Martinez Alvarez, Dev N Patel, Douglas Kondziolka, Kenneth Bernstein, Nuria Martinez Moreno, Manjul Tripathi, Herwin Speckter, Camilo Albert, Greg N Bowden, Ronald J Benveniste, L Dade Lunsford, Michael D Jenkinson, and Jason Sheehan.
• Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
• Neurosurgery. 2022 Jun 1; 90 (6): 750757750-757.

BackgroundThe optimal management of asymptomatic, presumed WHO grade I meningiomas remains controversial.ObjectiveTo define the safety and efficacy of stereotactic radiosurgery (SRS) compared with active surveillance for the management of patients with asymptomatic parafalcine/parasagittal (PFPS) meningiomas.MethodsData from SRS-treated patients from 14 centers and patients managed conservatively for an asymptomatic, PFPS meningioma were compared. Local tumor control rate and new neurological deficits development were evaluated in the active surveillance and the SRS-treated cohorts.ResultsThere were 173 SRS-treated patients and 98 patients managed conservatively in the unmatched cohorts. After matching for patient age and tumor volume, there were 98 patients in each cohort. The median radiological follow-up period was 43 months for the SRS cohort and 36 months for the active surveillance cohort (P = .04). The median clinical follow-up for the SRS and active surveillance cohorts were 44 and 36 months, respectively. Meningioma control was noted in all SRS-treated patients and in 61.2% of patients managed with active surveillance (P < .001). SRS-related neurological deficits occurred in 3.1% of the patients (n = 3), which were all transient. In the active surveillance cohort, 2% of patients (n = 2) developed neurological symptoms because of tumor progression (P = 1.0), resulting in death of 1 patient (1%).ConclusionUp-front SRS affords superior radiological PFPS meningioma control as compared with active surveillance and may lower the risk of meningioma-related permanent neurological deficit and/or death.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

20 keywords...

hide…