Posterior fossa meningiomas: perioperative predictors of extent of resection, overall survival and progression-free survival

  • Marco V. CorniolaEmail author
  • Jean-Michel Lemée
  • Michele Da Broi
  • Holger Joswig
  • Karl Schaller
  • Eirik Helseth
  • Torstein R. Meling
Original Article - Tumor - Meningioma
Part of the following topical collections:
  1. Tumor – Meningioma



Posterior fossa meningiomas (PFMs) often represent surgical challenges due to their proximity to neurovascular structures. Factors predicting the extent of resection (EOR), overall survival (OS), and progression-free survival (PFS) were identified and integrated in a prediction tool to offer evidence-based personalized therapeutic strategies.


All meningiomas managed surgically from 1990 to 2010 from a single-center were reviewed. A classification tree was created using the classification and regression tree recursive partitioning analysis that incorporated patient and tumor data available before surgery in order to predict the rates of gross total resection (GTR).


A total of 198 patients were identified (female-to-male ratio, 2.7; mean age, 59.1 years) and compared with 1271 supratentorial meningiomas (STMs) operated in the same institution during the same time period. GTR was achieved less often (59.6% versus 81.9%; p < 0.01) in PFMs than STMs. Preoperative neurological symptoms were predictive of higher Simpson grades (OR, 2.19 [1.05; 4.58]; p = 0.04). Age was associated with reduced OS (OR, 1.08 [1.04;1.12]; p < 0.001). A KPS ≥ 70 was associated with higher survival rates (OR, 2.70 [2.19;2.92]; p = 0.02). Higher WHO grades were associated with reduced OS (OR, 3.56 [1.02;12.47]; p = 0.05). The GTR rate varies from 80% in patients without a preoperative deficit to 40% patients with a preoperative deficit, younger than 60 years old, and with adjacent bone invasion.


This study provides a classification tree of the predictors of EOR in PFMs, based upon preoperative demographic, clinical, and radiological variables. An evidence-based management protocol with estimated EORs may guide the decision-making process in PFMs.


Posterior Fossa Meningioma Overall survival Progression-free survival 


Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The study was regulated by the Personal Data Act/Personal Health Data Filing System Act and approved by the Data Protection Official at OUH (2017/5204). Informed consent was not required according to the Personal Data Act/Personal Health Data Filing System Act.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Clinical Neurosciences, Division of NeurosurgeryGeneva University HospitalsGenèveSwitzerland
  2. 2.Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Faculty of MedicineUniversity of GenevaGenevaSwitzerland
  4. 4.Department of NeurosurgeryOslo University HospitalOsloNorway

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