Morbidity in survivors of child and adolescent meningioma
Article first published online: 19 SEP 2013
© 2013 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of the American Cancer Society.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Volume 119, Issue 24, pages 4350–4357, 15 December 2013
How to Cite
Kotecha, R. S., Jacoby, P., Cole, C. H. and Gottardo, N. G. (2013), Morbidity in survivors of child and adolescent meningioma. Cancer, 119: 4350–4357. doi: 10.1002/cncr.28366
- Issue published online: 3 DEC 2013
- Article first published online: 19 SEP 2013
- Manuscript Accepted: 20 AUG 2013
- Manuscript Received: 2 JUL 2013
The extent of initial surgical resection has been identified as the strongest prognostic indicator for survival in child and adolescent meningioma. Given the paucity of data concerning long-term outcome, the authors undertook a meta-analysis to analyze morbidity in survivors of this disease.
Individual patient data were obtained from 19 case series published over the last 23 years through direct communication with the authors. Ordinal logistic regression models were used to assess the influence of risk factors on morbidity.
Of 261 patients, 48% reported a completely normal life with no morbidity, and 25% had moderate/severe meningioma-associated morbidity at last follow-up. Multivariate analysis identified relapse as the only independent variable associated with an increased risk of morbidity (odds ratio, 4.02; 95% confidence interval, 2.11-7.65; P ≤ .001). Univariate analysis also revealed an increased risk for patients with neurofibromatosis (odds ratio, 1.90; 95% confidence interval, 1.04-3.48; P = .04). Subgroup analysis identified a higher incidence of morbidity among patients who had intracranial tumors with a skull base location compared with a nonskull base location (P ≤ .001). Timing at which morbidity occurred was available for 70 patients, with persistence of preoperative tumor-related symptoms in 67% and as a result of therapy in 20%.
The majority of survivors of child and adolescent meningioma had no or only mild long-term morbidity, whereas 25% had moderate/severe morbidity, with a significantly increased risk in patients with relapsed disease. In the majority, morbidity occurred as a consequence of the tumor itself, justifying aggressive surgery to achieve gross total resection. However, for patients with neurofibromatosis and skull base meningioma, a more cautious surgical approach should be reserved. Cancer 2013;119:4350–4357. © 2013 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of the American Cancer Society.