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

Champeaux-Depond, Charles; Weller, Joconde; Froelich, Sébastien; Resche‐Rigon, Matthieu

doi:10.1016/j.canep.2020.101875

Cited by 18 publications

(14 citation statements)

References 32 publications

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“…With the emergence of modern irradiation techniques such as intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT), the role of EBRT has significantly increased even as primary therapy for deep-situated meningiomas of which complete resection without permanent deficit is often difficult to achieve. As such, most meningiomas (72%) of our series are located on the skull base with middle skull base being the most common location (46.6%) vs. only 11.9% of cranial convexity meningiomas; the most common that usually constitutes around one quarter of all meningiomas [ 9 ]. This over-representation of skull base tumours may be a selection bias in the present cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who underwent the surgical resection of a meningioma between the first of January 2008 and the 31 December 2017 were included. Cases were selected using an algorithm combining two variables as described previously: the type of the surgical procedure identified by the Common Classification of Medical Acts (CCAM) and the primary diagnosis according to the International Classification of Diseases (ICD-10) [ 6 7 8 9 ]. Benign meningiomas were considered as corresponding to the D32 ICD-10 code, atypical to D42 and malignant to C70.…”

Section: Methodsmentioning

confidence: 99%

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Outcome After Protontherapy for Progression or Recurrence of Surgically Treated Meningioma

Champeaux-Depond

Weller

2021

Brain Tumor Res Treat

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Background To assess the outcome after meningioma surgery and protontherapy (PT). Methods We processed the French Système National des Données de Santé database to retrieve appropriate cases of meningiomas operated and irradiated between 2008 and 2017. Survival methods were implemented. Results One hundred ninety-three patients who received PT after meningioma surgery over a 10-year period were identified. Of the 193 patients, 75.6% were female. Median age at surgery was 50 years (interquartile range [IQR] 41–62). The median number of PT fractions was 31 (IQR 30–39) given over a median duration of 52 days (IQR 44–69). Fourteen patients (7.3%) also received photon radiotherapy and six patients (3.1%) stereotactic radiosurgery. Median follow-up was 4.4 years (IQR 3.86–4.71). Five-year progression-free survival (PFS) rate was 69% (95% confidence interval [CI] 62.1–76.6). For benign, atypical, and malignant meningioma, 5-year PFS rates were 71.5% (95% CI 64.4–79.4), 55.6% (95% CI 32.5–95), and 35.6% (95% CI 12.8–98.9), respectively ( p <0.01). In the adjusted regression, tumour location (hazard ratio [HR]=0.1, 95% CI 0.05–0.22, p <0.001), aggressive meningioma (HR=2.26, 95% CI 1.1–4.66, p =0.027), and the need of cerebrospinal fluid (CSF) insertion for hydrocephalus (HR=3.51, 95% CI 1.32–9.31, p =0.012) remained significantly associated to the PFS. All grades considered, 5-year overall survival (OS) rates was 89.7% (95% CI 84.6–95.1). For benign, atypical, and malignant meningioma, 5-year OS rates were 93% (95% CI 88.7–97.4), 76.4% (95% CI 51.4–100), and 44.4% (95% CI 16.7–100), respectively ( p <0.01). In the multivariable regression, an older age above 70 years (HR=5.95, 95% CI 2.09–16.89, p <0.001) associated to a high level of comorbidities (HR=5.31, 95% CI 1.43–19.78, p =0.013) and a malignant meningioma (HR=5.68, 95% CI 1.54–20.94, p =0.009) remained significantly associated to a reduced OS. Conclusion Five-year PFS and OS after meningioma surgery and PT is favourable but impaired for older patients with high level of morbidities, tumour of the convexity, malignant histopathology and for those requiring CSF shunting. Further inclusion and prolonged follow-up is required to assess other predictors such as sex, tumour volume, or given dose.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Outcome After Protontherapy for Progression or Recurrence of Surgically Treated Meningioma

Champeaux-Depond

Weller

2021

Brain Tumor Res Treat

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“…Patients who underwent the surgical resection of a meningioma between the first of January 2008 and to the 31 December 2017 were included. Cases were selected using an algorithm combining 2 variables as described previously: the type of the surgical procedure identified by the Common Classification of Medical Acts and the primary diagnosis according to the International Classification of Diseases (ICD-10) [ 3 , 5 , 18 , 19 ]. Benign meningiomas were considered as corresponding to the D32 ICD-10 codes, atypical to D42 and malignant to C70.…”

Section: Methodsmentioning

confidence: 99%

Functional Outcome After Spinal Meningioma Surgery. A Nationwide Population-Based Study

Champeaux-Depond

Penet

Weller³

et al. 2022

Neurospine

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Objective: To describe and analysed the functional outcome (FO) after spinal meningioma (SM) surgery.Methods: We processed the système national des données de santé (SNDS) i.e. , the French national administrative medical database to retrieve appropriate cases. We analysed the International Classification of Diseases 10 codes to assess the FO. Logistic models were implemented to search for variables associated with a favourable FO i.e. , a patient being independent at home without disabling symptom.Results: A total of 2,844 patients were identified of which 79.1% were female. Median age at surgery was 66 years, interquartile range (IQR) (56–75). Ninety-five point nine percent of the SMs were removed through a posterior ± lateral approach and 0.7% need an associated stabilisation. Benign meningioma represented 92.9% and malignant 2.1%. Median follow-up was 5.5 years, IQR (2.1–8), and at data collection 9% had died. The FO was good and increased along the follow-up: 84.3% of the patients were alive and had not associated symptoms at one year, 85.9% at 2 and 86.8% at 3 years. Nonetheless, 3 years after the surgery 9.8% of the alive patients still presented at least one disabling symptom of which 2.7% motor deficit, 3.3% bladder control problem, and 2.5% gait disturbance. One point seven percent were care-provider dependent and 2.1% chair or bedfast. In the multivariable logistic regression an older age at surgery (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.29–0.47, p < 0.001), a high level of comorbidities (OR, 0.71; 95% CI, 0.66–0.75, p < 0.001), and an aggressive tumor (OR, 0.49; 95% CI, 0.33–0.73; p < 0.001) were associated with a worse FO.Conclusion: FO after meningioma surgery is favourable but, may be impaired for older patients with a high level of comorbidities and aggressive tumor.

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“…In their study on the in uence of cyproterone acetate (CPA) on meningioma, they hypothesised that this feature never previously reported was likely related to a increased incidence of early cases. They found that the median age at meningioma surgery was signi cantly lower in patients who were treated by CPA (47 years, IQR [42][43][44][45][46][47][48][49][50][51][52][53][54]) compared to the non-CPA population (61 years, IQR [51 70], p <0.001) [20]. They observed a strong dose-effect relation between use of cyproterone acetate and risk of intracranial meningiomas and, thus postulated that the widespread use of synthetic progestogen in France has modi ed the age distribution of meningiomas cases in female patients [20].…”

Section: Age At Diagnosismentioning

confidence: 99%

WITHDRAWN: Descriptive epidemiology of 30,223 histopathologically confirmed meningiomas in France: 2006–2015

Depond,

Zouaoui,

Darlix

et al. 2023

Preprint

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Purpose To describe the epidemiology of meningioma operated in France between 2006 and 2015. Methods We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed meningioma in France. Descriptive methods were implemented. Results 30,223 meningiomas cases were operated on 28,424 patients, in 61 centres. Meningioma was 3 times more common in women (74.1% vs. 25.9%). Mean age at surgery was 58.5±13.9 years; 57.9±13.5 years for women vs.59.9 ±14.8 years for men (p<0.001). The incidence of meningioma surgery increased with age. Grade 1, 2, and 3 meningiomas accounted for 83.9%, 13.91% and, 2.19% respectively. The proportion of grade 2 significantly grew over the study period (p<0.001). There was a significant variability of meningioma grading by institutions, especially for grade 2 which spanned from 5.1% up to 22.4% (p <0.001). 89.05% of the patients had solely one meningioma surgery, 8.52% two and, 2.43% three or more. The number of surgeries was associated with the grade of malignancy (p <0.001). Conclusion The FBTBD is an effective source that comforts previous studies and, bring new information from 30,223 meningiomas cases operated on over a 10-year-long period. Three quarters of meningioma were removed in women. The incidence of meningioma surgery increased with age and, peaked at 58.5 years. They were predominantly benign with meningothelial subtype being the most common. However, the rate of grade 2 has significantly grown over the time, on contrary to malignant meningioma proportion, which remained rare and stable over time around 2%.

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

Cited by 18 publications

References 32 publications

Outcome After Protontherapy for Progression or Recurrence of Surgically Treated Meningioma

Outcome After Protontherapy for Progression or Recurrence of Surgically Treated Meningioma

Functional Outcome After Spinal Meningioma Surgery. A Nationwide Population-Based Study

WITHDRAWN: Descriptive epidemiology of 30,223 histopathologically confirmed meningiomas in France: 2006–2015

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