Residual or recurrent meningiomas after initial surgical resection are commonly treated with stereotactic radiosurgery (SRS), but progression of these tumors following radiosurgery is difficult to predict. We performed a retrospective review of 60 consecutive patients who underwent resection and subsequent Gamma Knife (Elekta AB, Stockholm, Sweden) radiosurgery for residual or recurrent meningiomas at our institution from 2001-2012. Patients were subdivided by Simpson resection grade and World Health Organization (WHO) grade. Cox multivariate regression and Kaplan-Meier analyses were performed to assess risk of tumor progression. There were 45 men (75%) and 15 women (25%) with a median age of 56.8 years (range 26.5-82 years). The median follow-up period was 34.9 months (range 6-108.4 months). Simpson grade 1-3 resection was achieved in 17 patients (28.3%) and grade 4 resection in 43 patients (71.7%). Thirty-four tumors (56.7%) were WHO grade 1, and 22 (36.7%) were WHO grade 2-3. Time from resection to SRS was significantly shorter in patients with Simpson grade 4 resection compared to grade 1-3 resection (p < 0.01), but did not differ by WHO grade (p = 0.17). Post-SRS complications occurred in five patients (8.3%). Overall, 19 patients (31.7%) experienced progression at a median of 15.3 months (range 1.2-61.4 months). Maximum tumor diameter >2.5 cm at the time of SRS (p = 0.02) and increasing WHO grade (p < 0.01) were predictive of progression in multivariate analysis. Simpson resection grade did not affect progression-free survival (p = 0.90). The mortality rate over the study period was 8.3%. SRS offers effective tumor control for residual or recurrent meningiomas following resection, especially for small benign tumors.
All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Physiology (medical)