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Surgical complications and recurrence factors for asymptomatic meningiomas: a single-center retrospective study

  • Original Article - Tumor - Meningioma
  • Published:
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Abstract 

Purpose

Observation is the first management option in asymptomatic meningiomas, but when an enlargement or mass effect is observed, surgery is indicated. This study is aimed at exploring risk factors for complications and recurrence after surgery for asymptomatic meningioma. We also examined the impact of preoperative tumor embolization, which is considered controversial.

Methods

We retrospectively reviewed 109 patients with primary asymptomatic meningiomas surgically treated at our institute between April 2007 and March 2021. Patients who only had headaches as a nonspecific complaint were included in the asymptomatic group. Complications, time to recurrence, and Glasgow Outcome Scale (GOS) score were the endpoints of the study. Risk factors for complications and recurrence were explored. Moreover, the effect of the resection on nonspecific headaches was also explored.

Results

The permanent postoperative complication rate related to the surgical procedure was 1.8%. Of the total, 107 patients (98.2%) with asymptomatic meningiomas who were surgically treated achieved a GOS score of 5 1 year after the operation. Preoperative headache was present in 31 patients and improved postoperatively in 21 patients. Multivariate analysis using the Cox proportional hazard model showed that preoperative tumor embolization with > 80% resolution of tumor staining (p < 0.001) was negatively related to recurrence, whereas age (p = 0.046) and Simpson grade IV resection (p = 0.041) were positively related to recurrence.

Conclusion

Although surgery for asymptomatic meningiomas can, in many cases, be safe, it is not free of complications Thus, surgical intervention for asymptomatic meningiomas should be considered cautiously. However, more than half the patients with headaches showed improvement. Simpson grade IV resection cases should be assessed for recurrence, and preoperative tumor embolization might be effective in controlling recurrence.

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Acknowledgements

We wish to thank all the staff at the participating institutions for their support in meningioma treatment, as well as the study participants and their families. We thank the staff of the Department of Biostatistics for their advice on the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Yokohama City University Medical Center, 4-57 Urafune, Yokohama, 2320024, Minami, Japan

    Taisuke Akimoto, Hibiki Yoshikawa, Shuto Fushimi, Ryosuke Takagi, Taishi Nakamura, Makoto Ohtake, Takashi Kawasaki & Katsumi Sakata

  2. Department of Neurosurgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 2360004, Japan

    Tetsuya Yamamoto

Authors
  1. Taisuke Akimoto
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  2. Hibiki Yoshikawa
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  3. Shuto Fushimi
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  4. Ryosuke Takagi
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  5. Taishi Nakamura
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  6. Makoto Ohtake
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  9. Tetsuya Yamamoto
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Contributions

T.A. and K.S. contributed to the conception and design of the study, acquisition of data, and analysis and interpretation of data. T.A., H.Y., S.F., R.T., T.N., M.O., T.K., and K.S. collected clinical data. T.A. wrote the draft and conducted the statistical analysis. K.S. and T.Y. supervised all aspects of this study. All the authors have read the final manuscript and approved its submission for publication. All authors attested to meeting the four ICMJE authorship criteria.

Corresponding author

Correspondence to Taisuke Akimoto.

Ethics declarations

Ethics approval

This study was approved by the Yokohama City University Medical Center (approval number B190200012).

Consent to participate

Due to the retrospective study design, the Ethics Committee of Yokohama City University Medical Center waived the requirement for written informed consent, offering participants an opt-out option, as per the Personal Information Protection Law and National Research Ethics Guidelines in Japan.

Competing interests

The authors declare no competing interests.

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Akimoto, T., Yoshikawa, H., Fushimi, S. et al. Surgical complications and recurrence factors for asymptomatic meningiomas: a single-center retrospective study. Acta Neurochir 165, 1345–1353 (2023). https://doi.org/10.1007/s00701-022-05420-6

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  • DOI: https://doi.org/10.1007/s00701-022-05420-6

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