Long-term Follow-up of Patients with Meningiomas Involving the Cavernous Sinus: Recurrence, Progression, and Quality of Life

Jesús, Orlando De; Sekhar, Laligam N.; Parikh, Hemen K.; Wright, Donald C.; Wagner, Douglas P.

doi:10.1097/00006123-199611000-00005

Cited by 128 publications

(101 citation statements)

References 9 publications

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“…1-12 38 The variation of total recurrence rates among the surgical series (from 0% to 17%, median 6.7%) is seemingly caused by the range of the follow up periods. [1][2][3][4][5][6][7][8][9][10][11][12] Furthermore, the recurrence/progression rates increase with the duration of follow up, and also seem to be influenced by tumour site and specific histopathological factors. 3 34 studies, proved that the long term recurrence rates of microsurgically treated meningiomas are often underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, microsurgical resection of these tumours is frequently associated with considerable aggravation or new onset of neurological impairment, [1][2][3][4][5][6][7][8][9][10][11][12] and meningioma recurrences are observed even when complete removal has been accomplished. 1 3-6 9 12 13 Therefore, surgery alone cannot be the ideal solution to treat all skull base meningiomas, and less invasive therapeutic options have to be considered not only as adjunctive but as alternative primary treatment.…”

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confidence: 99%

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Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Kreil¹,

Eustacchio²,

Weigl³

et al. 2007

Skull Base

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Kreil¹,

Eustacchio²,

Weigl³

et al. 2007

Skull Base

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“…As a consequence, several authors have emphasized the use of subtotal resection to limit the risk for permanent post-operative cranial nerve or the potential for vascular injury over complete resection. 7,9,12,23 The long-term outcome after subtotal resection of meningiomas within the cavernous sinus alone is, however, associated with an unacceptably high symptomatic recurrence rate. …”

mentioning

confidence: 99%

Surgical and Radiation Treatment of Skull Base Meningiomas

Cole¹,

Couldwell²

2008

US Neurology

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Meningiomas comprise approximately 20% of adult primary intracranial neoplasms.1 Of these, benign meningiomas are known to have an indolent growth pattern, usually without infiltration into adjacent nervous tissue. [2][3][4][5] Because meningiomas have a well-circumscribed character, surgery has historically been the preferred treatment when total resection can be achieved with reasonable morbidity. Surgical resection has resulted in five-, 10-, and 15-year progression-free rates of 93, 80, and 68%, respectively. 6 Despite the development of multiple techniques designed to minimize morbidity while obtaining a surgical cure, however, complete resection remains difficult and is not achievable in approximately 20-30% of presenting patients because of multiple regional involvement, severe adherence to or invasion of the brainstem, involvement of cranial nerves, or encasement of the vertebrobasilar circulation. 6-11 Currently, controversy exists as to whether skull base meningiomas, especially those involving the petroclivus and/or cavernous sinus, are best treated with radical resection, subtotal resection followed by radiosurgical treatment of the residual lesion, or radiosurgical treatment alone. Petroclival Tumors and Cavernous ExtensionMeningiomas of the petroclival region usually involve the petrous apex and the upper two-thirds of the clivus. Appropriately, cautious subtotal resection has become the preferred treatment to reduce post-operative morbidity, along with the addition of radiation treatment of tumor remnants. 18-21Meningiomas along the medial sphenoid wing that invade the cavernous sinus are also a treatment challenge because of the possibility of tumor infiltration of the traversing cranial nerves and internal carotid artery and, to a lesser degree, the involvement of the adjacent pituitary gland. 22 The goal of surgical cure must therefore take into account local invasion of neurovascular structures within the cavernous sinus. As a consequence, several authors have emphasized the use of subtotal resection to limit the risk for permanent post-operative cranial nerve or the potential for vascular injury over complete resection. 7,9,12,23 The long-term outcome after subtotal resection of meningiomas within the cavernous sinus alone is, however, associated with an unacceptably high symptomatic recurrence rate. 24 Radiosurgical TreatmentDespite the high symptomatic recurrence rate and microsurgical improvements over the past few years, subtotal resection of meningiomas along the skull base, particularly those within the petroclival and cavernous sinus locations, remains a desired surgical outcome because such limited resection lends an acceptable level of morbidity. 7,11,[25][26][27] Because of the unacceptable morbidity of radical resection, along with the high incidence of recurrence, adjuvant techniques for treating these tumors have been developed.Early studies from the 1980s demonstrated that external-beam field radiation therapy could provide durable local tumor control for those benign meningio...

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“…Pode incluir: observação, ressecação cirúrgica, hormonioterapia, radioterapia, quimioterapia, ou combinação destas atitudes. A escolha da terapêutica depende da avaliação dos fatores relacionados aos doentes (idade, desempenho, morbidades associadas, presença ou ausência de sintomas) e aos tumores (localização, dimensão, grau histológico) (De Jesús et al, 1996). A observação é facultada quando o tumor é assintomático, indolente ou diagnosticado incidentalmente.…”

Section: Tratamento -Efetividade E Complicaçõesunclassified

“…Quando a ressecação cirúrgica é incompleta e ou o meningeoma é de graus II ou III, advoga-se a adjuvância com radioterapia em razão de maior risco de recorrência (De Jesús et al, 1996). de hematoma intracraniano, a hipertensão intracraniana, a ressecação incompleta da lesão e má condição clínica pré-operatória.…”

Section: Grau V Biópsia Do Tumorunclassified

Radiocirurgia e radioterapia estereotática no tratamento de meningeomas sintomáticos do seio cavernoso

Correa¹

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Long-term Follow-up of Patients with Meningiomas Involving the Cavernous Sinus: Recurrence, Progression, and Quality of Life

Cited by 128 publications

References 9 publications

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Long-Term Experience of Gamma Knife Radiosurgery for Benign Skull Base Meningiomas

Surgical and Radiation Treatment of Skull Base Meningiomas

Radiocirurgia e radioterapia estereotática no tratamento de meningeomas sintomáticos do seio cavernoso

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