Neurosurgical treatment and outcome patterns of meningioma in Sweden: a nationwide registry-based study.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
02 2019
Historique:
received: 20 10 2018
accepted: 04 01 2019
pubmed: 25 1 2019
medline: 25 1 2020
entrez: 25 1 2019
Statut: ppublish

Résumé

Surgery is the main treatment modality for intracranial meningiomas, but data on short-term surgical outcome are limited. The aim of this Swedish nationwide registry-based study was to benchmark the 30-day complication rate in a cohort of meningioma patients using data from the Swedish brain tumor registry (SBTR). Furthermore, we investigated outcomes for asymptomatic patients. Data were collected from the SBTR for all adults with histopathologically verified intracranial meningioma between 2009 and 2015. Patient symptoms, tumor characteristics, and complications within 30 days postoperatively were analyzed. In total, 2324 patients, with a mean age of 58.7 years (SD 13.5), underwent surgery for intracranial meningioma and 14.1% of the patients were asymptomatic before the intervention. The most common symptom prior to treatment was focal deficit, which occurred in 1450 patients (62.4%). Moreover, within 30 days after surgery, 344 patients (14.8%) developed new neurological deficits and new-onset seizures occurred in 105 patients (4.5%), while 8.3% of asymptomatic patients developed neurological deficit and 3.7% new-onset seizures. Due to complications, reoperations were performed in 120 patients (5.2%). The postoperative 30-day mortality in the whole cohort was 1.5%. This study benchmarks the 30-day complication rate after meningioma surgery and provides outcome data in the highly relevant group of asymptomatic patients using data from the Swedish brain tumor registry. Since surgical decision-making is a careful consideration of short-term risk versus long-term benefit, this information may be useful for both caregivers and patients.

Sections du résumé

BACKGROUND
Surgery is the main treatment modality for intracranial meningiomas, but data on short-term surgical outcome are limited. The aim of this Swedish nationwide registry-based study was to benchmark the 30-day complication rate in a cohort of meningioma patients using data from the Swedish brain tumor registry (SBTR). Furthermore, we investigated outcomes for asymptomatic patients.
METHODS
Data were collected from the SBTR for all adults with histopathologically verified intracranial meningioma between 2009 and 2015. Patient symptoms, tumor characteristics, and complications within 30 days postoperatively were analyzed.
RESULTS
In total, 2324 patients, with a mean age of 58.7 years (SD 13.5), underwent surgery for intracranial meningioma and 14.1% of the patients were asymptomatic before the intervention. The most common symptom prior to treatment was focal deficit, which occurred in 1450 patients (62.4%). Moreover, within 30 days after surgery, 344 patients (14.8%) developed new neurological deficits and new-onset seizures occurred in 105 patients (4.5%), while 8.3% of asymptomatic patients developed neurological deficit and 3.7% new-onset seizures. Due to complications, reoperations were performed in 120 patients (5.2%). The postoperative 30-day mortality in the whole cohort was 1.5%.
CONCLUSION
This study benchmarks the 30-day complication rate after meningioma surgery and provides outcome data in the highly relevant group of asymptomatic patients using data from the Swedish brain tumor registry. Since surgical decision-making is a careful consideration of short-term risk versus long-term benefit, this information may be useful for both caregivers and patients.

Identifiants

pubmed: 30675656
doi: 10.1007/s00701-019-03799-3
pii: 10.1007/s00701-019-03799-3
pmc: PMC6373228
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

333-341

Subventions

Organisme : Vetenskapsr?det
ID : 2017-00944
Pays : International
Organisme : ALF-funding
ID : ALFGBG-716671
Pays : International

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Auteurs

Alba Corell (A)

Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. alba.corell@vgregion.se.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. alba.corell@vgregion.se.

Erik Thurin (E)

Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Neurology, Sahlgrenska University Hospital, Blå stråket 5, 41345, Gothenburg, Sweden.

Thomas Skoglund (T)

Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Dan Farahmand (D)

Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Roger Henriksson (R)

Regional Cancer Centre Stockholm, Stockholm, Gotland, Sweden.
Department of Radiation Science and Oncology, University hospital, Umeå, Sweden.

Bertil Rydenhag (B)

Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Sasha Gulati (S)

Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.

Jiri Bartek (J)

Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Asgeir Store Jakola (AS)

Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway.

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