A nationwide population-based study on overall survival after meningioma surgery.

Brain Neoplasms / mortality Female Humans Male Meningioma / mortality Middle Aged Survival Analysis Treatment Outcome
Database Meningioma Outcome Predictors SNDS Survival

Journal

Cancer epidemiology
ISSN: 1877-783X
Titre abrégé: Cancer Epidemiol
Pays: Netherlands
ID NLM: 101508793

Informations de publication

Date de publication:
02 2021
Historique:
received: 26 08 2020
revised: 17 11 2020
accepted: 05 12 2020
pubmed: 29 12 2020
medline: 13 4 2021
entrez: 28 12 2020
Statut: ppublish

Résumé

There are very few nationwide studies on meningioma outcome, the most common primary intracranial tumour. We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve all cases of meningiomas operated between 2007 and 2017. A survival analysis was performed. This nationwide study found 28 773 patients of which 75 % were female. Median age at surgery was 59 years, IQR[49-68]. Cranial convexity (24.4 %) and middle skull base (21.7 %) were the most common locations. 91.3 % of the tumours were benign and 2.6 % malignant.7.5 % of the patients underwent redo surgery, 9.1 % radiotherapy (RT) and 3.2 % stereotactic radiosurgery for recurrence. Median follow-up was 5.3 years 95 % CI [5.24-5.35]. 0.64 % of the patients died within a month of surgery and 2.1 % within a year. Overall survival (OS) rates at 5 and 10 years respectively were: 92.6 %, 95 %CI[92.3, 93] and 85 %, 95 %CI[84.3, 85.8]. In the multivariable analysis, female gender (HR = 0.64, 95 %CI[0.59, 0.69], p < 0.001), older age at surgery (HR= 1.07, 95 %CI[1.06, 1.07], p < 0.001), type 2 neurofibromatosis (HR= 3.89, 95 %CI[2.62, 5.76], p < 0.001), parasagittal (HR= 1.2, 95 %CI[1.05, 1.37], p = 0.00944) or falx cerebri location (HR= 1.18, 95 %CI[1.01, 1.37], p = 0.0343), atypical or (HR= 1.34, 95 %CI[1.15, 1.56], p < 0.001) malignant histology (HR= 2.34, 95 %CI[2.01, 2.73], p < 0.001), redo surgery (HR=1.81, 95 %CI[1.6, 2.04], p < 0.001), progressing meningioma (HR=1.34, 95 %CI[1.05, 1.71], p = 0.0175) or RT for recurrence (HR=2.17, 95 %CI[1.95, 2.4], p < 0.001) were established as independent prognostic factors of the OS. In this registry-based study, OS after meningioma surgery is good and is even better in women, younger adults and those with convexity and benign tumour. We also found that NF2 patients and those required redo surgery or additional treatment for uncontrolled meningioma disease are further at risk of death.

Sections du résumé

BACKGROUND
There are very few nationwide studies on meningioma outcome, the most common primary intracranial tumour.
METHODS
We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve all cases of meningiomas operated between 2007 and 2017. A survival analysis was performed.
RESULTS
This nationwide study found 28 773 patients of which 75 % were female. Median age at surgery was 59 years, IQR[49-68]. Cranial convexity (24.4 %) and middle skull base (21.7 %) were the most common locations. 91.3 % of the tumours were benign and 2.6 % malignant.7.5 % of the patients underwent redo surgery, 9.1 % radiotherapy (RT) and 3.2 % stereotactic radiosurgery for recurrence. Median follow-up was 5.3 years 95 % CI [5.24-5.35]. 0.64 % of the patients died within a month of surgery and 2.1 % within a year. Overall survival (OS) rates at 5 and 10 years respectively were: 92.6 %, 95 %CI[92.3, 93] and 85 %, 95 %CI[84.3, 85.8]. In the multivariable analysis, female gender (HR = 0.64, 95 %CI[0.59, 0.69], p < 0.001), older age at surgery (HR= 1.07, 95 %CI[1.06, 1.07], p < 0.001), type 2 neurofibromatosis (HR= 3.89, 95 %CI[2.62, 5.76], p < 0.001), parasagittal (HR= 1.2, 95 %CI[1.05, 1.37], p = 0.00944) or falx cerebri location (HR= 1.18, 95 %CI[1.01, 1.37], p = 0.0343), atypical or (HR= 1.34, 95 %CI[1.15, 1.56], p < 0.001) malignant histology (HR= 2.34, 95 %CI[2.01, 2.73], p < 0.001), redo surgery (HR=1.81, 95 %CI[1.6, 2.04], p < 0.001), progressing meningioma (HR=1.34, 95 %CI[1.05, 1.71], p = 0.0175) or RT for recurrence (HR=2.17, 95 %CI[1.95, 2.4], p < 0.001) were established as independent prognostic factors of the OS.
CONCLUSION
In this registry-based study, OS after meningioma surgery is good and is even better in women, younger adults and those with convexity and benign tumour. We also found that NF2 patients and those required redo surgery or additional treatment for uncontrolled meningioma disease are further at risk of death.

Identifiants

DOI: 10.1016/j.canep.2020.101875 PMID: 33360358
pubmed: 33360358
pii: S1877-7821(20)30209-5
doi: 10.1016/j.canep.2020.101875
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101875

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Charles Champeaux-Depond (C)

Department of Neurosurgery, Lariboisière Hospital, 75010, Paris, France; INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, France. Electronic address: Charles.Champeaux@gmail.com.

Joconde Weller (J)

Agence régionale de santé, 2bis, Avenue Georges Brassens, CS 61002 - 97743, Saint Denis CEDEX 9, France.

Sebastien Froelich (S)

Department of Neurosurgery, Lariboisière Hospital, 75010, Paris, France.

Matthieu Resche-Rigon (M)

INSERM U1153, Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), ECSTRRA Team, Université de Paris, France.

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Classifications MeSH

questionsmedicales.fr › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs du cerveau › A nationwide population-based study on overall...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A nationwide population-based study on overall...
questionsmedicales.fr › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs des méninges › Méningiome › A nationwide population-based study on overall...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › A nationwide population-based study on overall...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › A nationwide population-based study on overall...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › A nationwide population-based study on overall...