Natural history of elderly patients with asymptomatic meningiomas

Abstract

AbstractsObjective-For the treatment of elderly patients with asymptomatic meningiomas, it is important to determine their natural history. Based on results of follow up examinations, the natural history of such patients was clarified and prognostic factors concerning the potential of tumour growth in the aged were identified. Methods-The clinical records and imaging studies of 40 elderly (over 70 years) patients with asymptomatic meningiomas were analysed. The patients were followed up with repeated imaging studies, and changes in tumour size, clinical signs, and outcomes were evaluated. Results-There were 32 women and eight men with a mean age of 76.1 years. The mean follow up period was 38.4 months, ranging from 6 to 97 months. Six patients died during the follow up period from disorders other than the tumours, and one patient died as a result of the tumour. Twenty six patients (mean follow up period 41.8 months, range 10-97 months) showed no tumour growth. Fourteen patients showed tumour growth (mean follow up period 32.1 months, range 6-88 months). Five (four men and one woman) of these patients became symptomatic. Based on imaging analysis (1) calcification of the tumour was associated with no tumour growth (p=0.036), and (2) the tumour size at the initial diagnosis was related to subsequent tumour growth (p=0.016). Other possible factors related to tumour growth included sex and hyperintensity on MRI T2 weighted images. Conclusion-In elderly patients with asymptomatic meningiomas, careful clinical follow up with imaging studies is important. The imaging features mentioned may contribute to prediction of tumour growth. (J Neurol Neurosurg Psychiatry 2000;68:25-28)

Clinical features and surgical management of intracranial meningiomas in the elderly

“…However, the risk of surgical treatment must be balanced against the morbidity due to tumor growth that is associated with a conservative treatment. Previous studies have investigated the natural history of intracranial meningiomas (26)(27)(28)(29)(30). The growth rate of intracranial meningiomas has been reported as 2.4-5.3 mm per year (27)(28)(29).…”

“…Previous studies have investigated the natural history of intracranial meningiomas (26)(27)(28)(29)(30). The growth rate of intracranial meningiomas has been reported as 2.4-5.3 mm per year (27)(28)(29). Other studies have reported that hyperintensity on T2-weighted imaging, a non-skull base location and the absence of calcification on imaging are considered positive indicators of tumor growth in intracranial meningiomas (30,31).…”

Reliability of the Size Evaluation Method for Meningiomas: Maximum Diameter, ABC/2 Formula, and Planimetry Method

“…Among the several methods that have been previously used to evaluate the size of meningiomas by computed tomography (CT) or magnetic resonance imaging (MRI), the maximum diameter has been used to analyze the natural history of meningiomas (5)(6)(7)(8)(9). It is the simplest procedure; however, it is uncertain whether the maximum diameter accurately reflects the real volume of the tumor.…”

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

“…The mean age of patients in these nine studies with growing tumors was 59.74 ± 0.15 years (range of 17 to 83 years) while the mean age of patients with non-growing tumors was 63.95 ± 0.09 years (range of 22 to 88 years). Eleven studies reported M: F ratios in growing versus non-growing tumors [3,4,5,7,9,10,11,13,16,17,22]. In these studies, the M: F ratio in patients with growing tumors was 33:143 with males comprising 18.75% of the population with growing meningiomas.…”

“…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.…”