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Surgical treatment and prognostic analysis of petroclival meningiomas

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Author:
No author available
Journal Title:
Chinese Journal of Neurosurgery
Issue:
4
DOI:
10.3760/cma.j.issn.1001-2346.2012.04.002
Key Word:
脑膜瘤;岩斜区;乙状窦前;预后;经岩骨入路;MeHningioma;Petroclival;Presigmoid;Prognosis;Transpetrosal approach

Abstract: Objective To analyze the long- term surgical outcomes and prognostic factors of petroclival meningiomas.Methods Clinical data of 426 cases of petroclival meningiomas were retrospectively analyzed and followed - up to evaluate the prognostic factors of outcomes and long - term survival.The pre - and post - operative status of patient was evaluated by Karnofsky Performance Scale (KPS).Results After a mean follow- up duration of 71.2 months,314 patients (85 males and 229 females) were included in the recent study with a mean preoperative KPS of 72.9 ± 10.5.The most frequent approach was presigmoid transpetrosal approach (53.5%),complete resection (Simpson Grade Ⅰ or Ⅱ ) was achieved in 53.8% patients,and the surgical mortality was 2.1%.Postoperative KPS at discharge and at recent evaluation was 65.5 ± 16.1and 74.2 ± 28.2 respectively.Recurrence was found in 28 patients and 23 patients died during follow - up.Preoperative KPS,relationships between tumor and brain stem,vessels and nerves were independent prognostic factors of recent KPS and long - term survival.The overall survival rates were 93.0% at 5 years,90.6% at 10,and 70.0% at 15 years.Conclusions Surgical treatment was the first and the best option for petroclival meningiomas.With regard of neurological function and life quality,gross total resection and individual treatment should be achieved as far as possible.Patients with incomplete resection should be followed - up with MRI scan regularly to decide whether to undergoradiotherapy.Aggressive treatment should be administered for patients with recurrence.

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