Clinical Significance of Long-Term Follow-Up of Children with Posttraumatic Skull Base Fracture

Introduction. Seizure following meningioma surgery is common and management may be challenging. Identifying risk factors may help physicians to initiate optimal medical management. The aim of this study is to report seizure outcome and risk factors for perioperative seizure. Materials and Methods. Sixty-three adult patients who underwent supratentorial meningioma resection were included, and perioperative data and long-term follow-up were provided in this retrospective study. Binary logistic regression analysis was used to identify the risk factors for perioperative seizure and postoperative late seizure. Results. The results showed that 20 (37.1 %) patients had preoperative seizure and 10 (50 %) patients were seizure free at the long-term follow-up. Absence of headache was associated with preoperative seizure (p=0.002) while presence of early seizure was significant predictor for postoperative late seizure (p=0.03). Although not significant, occurrence of surgical complications (p=0.08) and non-skull base location (p=0.06) tended toward being a significant risk factor for postoperative late seizure. Conclusion. Presence of early seizures, surgical complications and locations out of skull base may direct postoperative anti-epileptic treatment to decrease seizure incidence which, indeed, increases quality of life for patients with meningioma.

Download Full-text

The applicability of established clinical and histopathological risk factors for tumor recurrence during long-term postoperative care in meningioma patients

Neurosurgical Review ◽

10.1007/s10143-021-01697-w ◽

2021 ◽

Author(s):

Swenja Lüthge ◽

Dorothee Cäcilia Spille ◽

Andrea Ulrike Steinbicker ◽

Stephanie Schipmann ◽

Eileen Maria Susanne Streckert ◽

...

Keyword(s):

Risk Factors ◽

Skull Base ◽

Tumor Recurrence ◽

Skull Base Tumor ◽

High Grade ◽

Entire Cohort ◽

Long Term Follow Up ◽

Base Location

Abstract Risk factors to predict late-onset tumor recurrence in meningioma patients are urgently needed to schedule control intervals during long-term follow-up. We therefore analyzed the value of established risk factors for postoperative meningioma recurrence for the prediction of long-term prognosis. Correlations of clinical and histopathological variables with tumor relapse after 3, 5, and 10 years following microsurgery were analyzed in uni- and multivariate analyses, and compared to findings in the entire cohort. In the entire cohort (N = 1218), skull base location (HR: 1.51, 95%CI 1.05–2.16; p = .026), Simpson ≥ IV resections (HR: 2.41, 95%CI 1.52–3.84; p < .001), high-grade histology (HR: 3.70, 95%CI 2.50–5.47; p < .001), and male gender (HR: 1.46, 95%CI 1.01–2.11; p = .042) were independent risk factors for recurrence. Skull base location (HR: 1.92, 95%CI 1.17–3.17; p = .010 and HR: 2.02, 95%CI 1.04–3.95; p = .038) and high-grade histology (HR: 1.87, 95%CI 1.04–3.38; p = .038 and HR: 2.29, 95%CI 1.07–4.01; p = .034) but not subtotal resection (HR: 1.53, 95%CI .68–3.45; p = .303 and HR: 1.75, 95%CI .52–5.96; p = .369) remained correlated with recurrence after a recurrence-free follow-up of ≥ 3 and ≥ 5 years, respectively. Postoperative tumor volume was related with recurrence in general (p < .001) but not beyond a follow-up of ≥ 3 years (p > .05). In 147 patients with a follow-up of ≥ 10 years, ten recurrences occurred and were not correlated with any of the analyzed variables. Skull base tumor location and high-grade histology but not the extent of resection should be considered when scheduling the long-term follow-up after meningioma surgery. Recurrences ≥ 10 years after surgery are rare, and predictors are lacking.

Download Full-text