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Surgical Experience of Infratentorial Meningiomas : Clinical Series at a Single Institution during the 20-Year Period

  • Jung, Min-Ho (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Moon, Kyung-Sub (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Lee, Kyung-Hwa (Department of Pathology, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jang, Woo-Youl (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jung, Tae-Young (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jung, Shin (Department of Neurosurgery, Brain Tumor Clinic & Gamma Knife Center, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital & Medical School)
  • Received : 2013.12.24
  • Accepted : 2014.06.11
  • Published : 2014.06.28

Abstract

Objective : Based on surgical outcomes of patients with infratentorial meningiomas surgically treated at our institution, we analyzed the predictors for surgical resection, recurrence, complication, and survival. Methods : Of surgically treated 782 patients with intracranial meningioma, 158 (20.2%) consecutive cases of infratentorial location operated on between April 1993 and May 2013 at out institute were reviewed retrospectively. The patients had a median age of 57.1 years (range, 16-77 years), a female predominance of 79.7%, and a mean follow-up duration of 48.4 months (range, 0.8-242.2 months). Results : Gross total resection (Simpson's grade I & II) was achieved in 81.6% (129/158) of patients. Non-skull base location was an independent factor for complete resection. The recurrence rate was 13.3% (21/158) and the 5-, 10-, and 15-year recurrence rates were 8.2%, 12.0%, and 13.3%, respectively. Benign pathology, postoperative KPS over than 90, low peritumoral edema, and complete resection were significantly associated with longer recurrence-free survival rate. The 5-, 10-, and 15-year survival rates were 96.2%, 94.9%, and 94.9%, respectively. Benign pathology, postoperative KPS over than 90 and complete resection were significantly associated with a longer survival rate. The permanent complication rate was 13% (21/158). Skull base location and postoperative KPS less than 90 were independent factors for the occurrence of permanent complication. Conclusion : Our experience shows that infratentorial meningiomas represent a continuing challenge for contemporary neurosurgeons. Various factors are related with resection degree, complications, recurrence and survival.

Keywords

References

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