Advertisement

European Spine Journal

, Volume 25, Issue 12, pp 4025–4032 | Cite as

Long-term recurrence rates after the removal of spinal meningiomas in relation to Simpson grades

  • Chi Heon Kim
  • Chun Kee ChungEmail author
  • Sun-Ho Lee
  • Tae-Ahn Jahng
  • Seung-Jae Hyun
  • Ki-Jeong Kim
  • Sang Hoon Yoon
  • Eun-Sang Kim
  • Whan Eoh
  • Hyun-Jib Kim
  • Kyoung-Tae Kim
  • Joo-Kyung Sung
  • Yunhee Choi
Original Article

Abstract

Purpose

Simpson grade II removal (coagulation of the dural attachment after gross total removal) of spinal meningioma is considered an acceptable alternative, but increased recurrence after more than 10 years has been reported. More attention must be paid to the long-term surgical outcomes after Simpson grade II removal.

Methods

A retrospective review was performed for 20 patients (M:F = 5:15; age, 59 ± 9 years) with Simpson grade II removal (mean follow-up period, 12.9 years; range 10.0–17.5). Magnetic resonance (MR) imaging was conducted in 17 patients at 88 ± 52 months (range 12–157). During the same period, Simpson grade I removal (removal of the dural origin) was performed in 21 patients (follow-up, 89 ± 87 months; range 9–316). Radiological recurrence was defined as a visible tumor on a follow-up MR image, and clinical tumor recurrence was defined as the recurrence of symptoms.

Results

At the final follow-up, neurological symptoms had improved in 16/20 patients and remained stable in 4/20. A recurrent tumor was detected in one patient due to increased back pain at 92 months postoperative, but the symptom was stable without surgery until the last follow-up (124 months). The radiological and clinical recurrence-free survival periods were 150 ± 7 months (95 % CI 136–163) and 204 ± 6 months (95 % CI 193–215), respectively. There was no recurrence after Simpson grade I removal, whereas neurological deterioration occurred in two patients after surgery.

Conclusions

Simpson grade II removal may be an alternative option if the risk of complications with Simpson grade I removal is expected to be high.

Keywords

Spinal meningiomas Meningiomas Recurrence Simpson grade Surgery 

Notes

Compliance with ethical standards

Disclosure and funding source

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2010-0028631). The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. This study was approved by the institutional review board of the Seoul National University Hospital Clinical Research Institute (IRB No. 1306-106-500).

References

  1. 1.
    King AT, Sharr MM, Gullan RW, Bartlett JR (1998) Spinal meningiomas: a 20-year review. Br J Neurosurg 12:521–526CrossRefPubMedGoogle Scholar
  2. 2.
    Solero CL, Fornari M, Giombini S, Lasio G, Oliveri G, Cimino C, Pluchino F (1989) Spinal meningiomas: review of 174 operated cases. Neurosurgery 25:153–160CrossRefPubMedGoogle Scholar
  3. 3.
    Riad H, Knafo S, Segnarbieux F, Lonjon N (2013) Spinal meningiomas: surgical outcome and literature review. Neurochirurgie 59:30–34. doi: 10.1016/j.neuchi.2012.10.137 CrossRefPubMedGoogle Scholar
  4. 4.
    Yoon SH, Chung CK, Jahng TA (2007) Surgical outcome of spinal canal meningiomas. J Korean Neurosurg Soc 42:300–304. doi: 10.3340/jkns.2007.42.4.300 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    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 37:E617–E623. doi: 10.1097/BRS.0b013e31824167f1 CrossRefPubMedGoogle Scholar
  6. 6.
    Cohen-Gadol AA, Zikel OM, Koch CA, Scheithauer BW, Krauss WE (2003) Spinal meningiomas in patients younger than 50 years of age: a 21-year experience. J Neurosurg 98:258–263PubMedGoogle Scholar
  7. 7.
    Kayaselcuk F, Zorludemir S, Bal N, Erdogan B, Erdogan S, Erman T (2004) The expression of survivin and Ki-67 in meningiomas: correlation with grade and clinical outcome. J Neurooncol 67:209–214CrossRefPubMedGoogle Scholar
  8. 8.
    Yamasaki F, Yoshioka H, Hama S, Sugiyama K, Arita K, Kurisu K (2000) Recurrence of meningiomas. Cancer 89:1102–1110CrossRefPubMedGoogle Scholar
  9. 9.
    Lanzafame S, Torrisi A, Barbagallo G, Emmanuele C, Alberio N, Albanese V (2000) Correlation between histological grade, MIB-1, p53, and recurrence in 69 completely resected primary intracranial meningiomas with a 6 year mean follow-up. Pathol Res Pract 196:483–488. doi: 10.1016/S0344-0338(00)80050-3 CrossRefPubMedGoogle Scholar
  10. 10.
    Maiuri F, De Caro ML, de Divitiis O, Vergara P, Mariniello G (2011) Spinal meningiomas: age-related features. Clin Neurol Neurosurg 113:34–38. doi: 10.1016/j.clineuro.2010.08.017 CrossRefPubMedGoogle Scholar
  11. 11.
    Roser F, Nakamura M, Bellinzona M, Ritz R, Ostertag H, Tatagiba MS (2006) Proliferation potential of spinal meningiomas. Eur Spine J 15:211–215. doi: 10.1007/s00586-005-0937-z CrossRefPubMedGoogle Scholar
  12. 12.
    Qi ST, Liu Y, Pan J, Chotai S, Fang LX (2012) A radiopathological classification of dural tail sign of meningiomas. J Neurosurg 117:645–653. doi: 10.3171/2012.6.JNS111987 CrossRefPubMedGoogle Scholar
  13. 13.
    Prayson RA, Chamberlain WA, Angelov L (2010) Clear cell meningioma: a clinicopathologic study of 18 tumors and examination of the use of CD10, CA9, and RCC antibodies to distinguish between clear cell meningioma and metastatic clear cell renal cell carcinoma. AIMM 18:422–428. doi: 10.1097/PAI.0b013e3181dd35d2 PubMedGoogle Scholar
  14. 14.
    Schaller B (2005) Spinal meningioma: relationship between histological subtypes and surgical outcome? J Neurooncol 75:157–161CrossRefPubMedGoogle Scholar
  15. 15.
    Kim CH, Chung CK (2011) Surgical outcome of a posterior approach for large ventral intradural extramedullary spinal cord tumors. Spine 36:E531–E537. doi: 10.1097/BRS.0b013e3181dc8426 CrossRefPubMedGoogle Scholar
  16. 16.
    Voulgaris S, Alexiou GA, Mihos E, Karagiorgiadis D, Zigouris A, Fotakopoulos G, Drosos D, Pahaturidis D (2010) Posterior approach to ventrally located spinal meningiomas. Eur Spine J 19:1195–1199. doi: 10.1007/s00586-010-1295-z CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Setzer M, Vatter H, Marquardt G, Seifert V, Vrionis FD (2007) Management of spinal meningiomas: surgical results and a review of the literature. Neurosurg Focus 23:E14. doi: 10.3171/FOC-07/10/E14 CrossRefPubMedGoogle Scholar
  18. 18.
    Klekamp J, Samii M (1999) Surgical results for spinal meningiomas. Surg Neurol 52:552–562. doi: 10.1016/S0090-3019(99)00153-6 CrossRefPubMedGoogle Scholar
  19. 19.
    Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Lee SH, Chung CK, Kim CH, Yoon SH, Hyun SJ, Kim KJ, Kim ES, Eoh W, Kim HJ (2013) Long-term outcomes of surgical resection with or without adjuvant radiation therapy for treatment of spinal ependymoma: a retrospective multicenter study by the Korea Spinal Oncology Research Group. Neuro Oncol 15:921–929. doi: 10.1093/neuonc/not038 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Sohn S, Chung CK, Park SH, Kim ES, Kim KJ, Kim CH (2013) The fate of spinal schwannomas following subtotal resection: a retrospective multicenter study by the Korea spinal oncology research group. J Neurooncol 114:345–351. doi: 10.1007/s11060-013-1190-7 CrossRefPubMedGoogle Scholar
  22. 22.
    McCormick PC, Torres R, Post KD, Stein BM (1990) Intramedullary ependymoma of the spinal cord. J Neurosurg 72:523–532. doi: 10.3171/jns.1990.72.4.0523 CrossRefPubMedGoogle Scholar
  23. 23.
    Sohn S, Chung CK (2013) Conventional posterior approach without far lateral approach for ventral foramen magnum meningiomas. J Korean Neurosurg Soc 54:373–378. doi: 10.3340/jkns.2013.54.5.373 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Park SB, Jahng TA, Kim CH, Chung CK (2009) Thoracic and lumbar laminoplasty using a translaminar screw: morphometric study and technique. J Neurosurg Spine 10:603–609. doi: 10.3171/2009.2.SPINE08257 CrossRefPubMedGoogle Scholar
  25. 25.
    Yamamuro K, Seichi A, Kimura A, Kikkawa I, Kojima M, Inoue H, Hoshino Y (2012) Histological investigation of resected dura mater attached to spinal meningioma. Spine 37:E1398–E1401. doi: 10.1097/BRS.0b013e318268c419 CrossRefPubMedGoogle Scholar
  26. 26.
    Postalci L, Tugcu B, Gungor A, Guclu G (2011) Spinal meningiomas: recurrence in ventrally located individuals on long-term follow-up; a review of 46 operated cases. Turk Neurosurg 21:449–453. doi: 10.5137/1019-5149.JTN.3518-10.2 PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Chi Heon Kim
    • 1
    • 2
    • 3
    • 4
  • Chun Kee Chung
    • 1
    • 2
    • 3
    • 4
    • 5
    Email author
  • Sun-Ho Lee
    • 6
  • Tae-Ahn Jahng
    • 2
    • 3
    • 4
    • 7
  • Seung-Jae Hyun
    • 2
    • 3
    • 4
    • 7
  • Ki-Jeong Kim
    • 2
    • 3
    • 4
    • 7
  • Sang Hoon Yoon
    • 8
  • Eun-Sang Kim
    • 6
  • Whan Eoh
    • 6
  • Hyun-Jib Kim
    • 2
    • 3
    • 4
    • 7
  • Kyoung-Tae Kim
    • 9
  • Joo-Kyung Sung
    • 9
  • Yunhee Choi
    • 10
  1. 1.Department of NeurosurgerySeoul National University HospitalSeoulSouth Korea
  2. 2.Department of NeurosurgerySeoul National University College of MedicineSeoulSouth Korea
  3. 3.Neuroscience Research InstituteSeoul National University Medical Research CenterSeoulSouth Korea
  4. 4.Clinical Research InstituteSeoul National University HospitalSeoulSouth Korea
  5. 5.Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulSouth Korea
  6. 6.Department of Neurosurgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  7. 7.Department of NeurosurgerySeoul National University Bundang HospitalSung-Nam, Kyung-giSouth Korea
  8. 8.Department of NeurosurgeryThe Armed Forces Capital HospitalSung-Nam, Kyung-giSouth Korea
  9. 9.Department of NeurosurgeryKyungpook National University HospitalTaegu, KyungpookSouth Korea
  10. 10.Medical Research Collaborating CenterSeoul National University College of MedicineSeoulSouth Korea

Personalised recommendations