Growth curve analysis of asymptomatic and symptomatic meningiomas

Abstract

Meningiomas sometimes appear to stop growing after attaining a large size. Commonly used exponential growth models do not reflect this phenomenon. We attempted to find the best curve to simulate their growth. Fifty-two patients with meningioma were followed up for 3.1-21.7 years (mean 7.5 years) with four or more imaging studies each. Thirty-one patients had asymptomatic tumors. The other 21 patients with residual or recurrent tumor were followed up after surgery. Time-volume curves for each tumor were plotted. Nonlinear regression analyses were performed against power, exponential, logistic, and Gompertzian curves. Time-volume curves corresponded to the Gompertzian and logistic growth curves better than to power or exponential curves. When simulating time-volume curves with Gompertzian curves, the majority of benign meningiomas began to slow their growth before patient age of 80 years. Twenty-three of 31 asymptomatic meningiomas had already passed the inflection point before diagnosis. In contrast, this happened less frequently in symptomatic tumors. Especially, all six atypical meningiomas continued to grow quasi-exponentially. Sigmoid curves that approach a plateau were better descriptors of the growth of benign meningiomas than were curves of unlimited growth. However, atypical meningiomas were unlikely to slow their growth.

The Natural Course of Incidental Intracranial Meningiomas: Systematic Review and Meta-Analysis.

“…Nine of them could be statistically evaluated in our meta analysis [4,5,7,9,11,13,16,17,21], calcification was associated with significantly reduced risk of growth (P= 0.001). Furthermore Nakusa etal and Jadid etal [8,12] concluded the same results with different way of calculation. Only Hashiba et al reported that the presence of calcifications was more frequently observed in lesions that followed a linear growth pattern than in those following an exponential pattern (P= 0.05) [5] .…”

“…Studies by Yoneoka et al , Herscovici et al ,Oya etal and Nakusa etal found patients with growing tumors were younger than those with non-growing tumors. Regarding growth curve analysis Nakusa reported that majority of benign meningiomas began to slow their growth before age of 80 years [12]. From our meta-analysis, we found that the overall effect suggests that growth was more likely in young age patients (P<0.001).…”

“…Published reports are often limited by a retrospective study design, small sample size, and short follow-up period. [1][2][3][4][5][6][7][8][9][10][11][12][13][14]16,17,19,[21][22][23] A systematic review and meta-analysis of the studies currently available allows for a better understanding of the natural course of asymptomatic meningiomas, a platform for more research, and a foundation on which a standardized guideline for following these tumors may be built.…”

Silent meningioma: a cause of quadriperesis in total knee arthroplasty

“…3 Only 3%-6% of clinically detected asymptomatic meningiomas later become symptomatic. 5 When symptomatic, intracranial meningiomas present a wide variety of symptoms arising from the compression of adjacent structures, direct invasion of or reactive changes in the adjacent brain tissue, and obstruction of cerebrospinal fluid pathways, cortical veins, or major venous sinuses.…”

“…2 Meningiomas are benign, slow growing tumours with a long initial asymptomatic phase. 3 The neurological deficit seemed to be related to the tumour location and size, and the severity of the peritumoural oedema. The considerable peritumoural oedema, probably related to their cellular morphology and ability to release vasoactive substances.…”