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Meningiomas: skull base versus non-skull base

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Abstract

To identify differences between skull base meningiomas (SBM) and non-skull base meningiomas (NSBM). All adult patients (18.0–69.9 years) operated for intracranial meningiomas between 1990 and 2010 at our institution were investigated. Al-Mefty’s definition was used to dichotomize tumors into SBM and NSBM. Overall, 1148 consecutive patients were identified. Median age at surgery was 54.2 years [18.1–69.9]. Median follow-up was 7.4 years [0.0–20.9]. There were 562 patients (49%) with SBM and 586 (51%) with NSBM. The two groups were similar with respect to patient age, follow-up time, and number of patients. Overall female-to-male ratio was 2.6:1, but 3.2:1 in SBM and 2.2:1 in NSBM (p < 0.005). With respect to presenting symptoms, SBMs had more often neurological deficits (risk ratio (RR) 1.4; p < 0.0001) and less often seizures (RR 0.4; p < 0.0001). Gross total resections were less frequent in SBM than NSBM (62 vs 84%) (RR 1.3; p < 0.0001). SBMs had a lower risk of WHO grades II and III histology (4.5 vs 9.5%) (RR 0.5; p < 0.001). Worsening of neurological function was more frequent in SBM (21 vs 121%) (RR 1.8; p < 0.001). Retreatment-free survival at 5, 10, and 15 years, respectively, was 80, 70, and 62% for SBM versus 90, 82, and 74% for NSBM (p < 0.0001). Overall survival at 5, 10, and 15 years, respectively, was 93, 85, and 78% for SBM and 96, 91, and 79% for NSBM (p = 0.14). Patients with SBMs had more new-onset neurological deficits and significantly shorter retreatment-free survivals, but this did not adversely affect the overall survival.

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Acknowledgements

The authors would like to thank Bernt Filip Hasseleid, MD; Andreas Mathisen, MD; Andreas Hessen Schei, MD; and Kristina M Ødegaard, MD, for their valuable contributions in collecting data for this manuscript.

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Authors and Affiliations

  1. Faculty of Medicine, University of Oslo, N-0027, Oslo, Norway

    Torstein R. Meling, Michele Da Broi & Eirik Helseth

  2. Department of Neurosurgery, Oslo University Hospital, Oslo, Norway

    Torstein R. Meling & Eirik Helseth

  3. Department of Pathology, Section of Neuropathology, Rigshospitalet, Copenhagen, Denmark

    David Scheie

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Meling, T.R., Da Broi, M., Scheie, D. et al. Meningiomas: skull base versus non-skull base. Neurosurg Rev 42, 163–173 (2019). https://doi.org/10.1007/s10143-018-0976-7

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