Meningioma surgery: Difference between revisions

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*As an alternative to surgery, stereotactic radiosurgery can be used either as a first line treatment or at recurrence.<ref name="pmid20056312">{{cite journal| author=Alexiou GA, Gogou P, Markoula S, Kyritsis AP| title=Management of meningiomas. | journal=Clin Neurol Neurosurg | year= 2010 | volume= 112 | issue= 3 | pages= 177-82 | pmid=20056312 | doi=10.1016/j.clineuro.2009.12.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20056312  }} </ref>  
*As an alternative to surgery, stereotactic radiosurgery can be used either as a first line treatment or at recurrence.<ref name="pmid20056312">{{cite journal| author=Alexiou GA, Gogou P, Markoula S, Kyritsis AP| title=Management of meningiomas. | journal=Clin Neurol Neurosurg | year= 2010 | volume= 112 | issue= 3 | pages= 177-82 | pmid=20056312 | doi=10.1016/j.clineuro.2009.12.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20056312  }} </ref>  
* Radiotherapy is an option that can be used in the treatment of meningioma but, surgery is usually preferred. This is based on symptoms, age, radiological features, postoperative morbidity, patient preference and when a definite diagnosis is necessary.<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref>  
* Radiotherapy is an option that can be used in the treatment of meningioma but, surgery is usually preferred. This is based on symptoms, age, radiological features, postoperative morbidity, patient preference and when a definite diagnosis is necessary.<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref>  
* The predominant therapy for meningioma is surgical resection. Adjunctive [[radiation therapy]] may be required among certain patients.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015</ref>
* Transarterial [[embolization]] has recently became a standard procedure in the preoperative management.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015</ref>
* Transarterial [[embolization]] has recently became a standard procedure in the preoperative management.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015</ref>
* Surgical resection procedures of meningioma include:<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015</ref><ref name="R">Simpson grade. Radiopaedia(2015) http://radiopaedia.org/articles/simpson-grade Accessed on September, 25 2015</ref><ref name="N">Simpson Grading System. Neurosurgic.com(2015) http://www.neurosurgic.com/index.php?option=com_content&view=article&id=846:simpson-grading-system-for-removal-of-meningeomas&catid=152:usefulinfo&Itemid=603 Accessed on September, 25 2015</ref>
* Surgical resection procedures of meningioma include:<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015</ref><ref name="R">Simpson grade. Radiopaedia(2015) http://radiopaedia.org/articles/simpson-grade Accessed on September, 25 2015</ref><ref name="N">Simpson Grading System. Neurosurgic.com(2015) http://www.neurosurgic.com/index.php?option=com_content&view=article&id=846:simpson-grading-system-for-removal-of-meningeomas&catid=152:usefulinfo&Itemid=603 Accessed on September, 25 2015</ref>

Revision as of 17:10, 28 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

The predominant therapy for meningioma is surgical resection. Adjunctive radiation therapy may be required among certain patients.[1] The Simpson criteria for meningioma correlates the degree of surgical resection completeness with the probability of post-surgical tumor recurrence.[1][2][3] Surgical resection is not recommended among patients with asymptomatic stable meningioma.[1]

Surgery

  • Surgery is the preferred method for treating a meningioma.[4]
  • The decision to undergo surgery is based on age, symptoms, radiological features, postoperative morbidity, and patient preference.[4]
  • The surgery is successful if the tumor is completely removed. This is considered curative.[5]
  • As an alternative to surgery, stereotactic radiosurgery can be used either as a first line treatment or at recurrence.[5]
  • Radiotherapy is an option that can be used in the treatment of meningioma but, surgery is usually preferred. This is based on symptoms, age, radiological features, postoperative morbidity, patient preference and when a definite diagnosis is necessary.[4]
  • Transarterial embolization has recently became a standard procedure in the preoperative management.[1]
  • Surgical resection procedures of meningioma include:[1][2][3]
  • Complete meningioma resection, with excision of any involved bone, venous sinuses, and dural attachments
  • Complete meningioma resection and coagulation of dural attachment
  • Partial meningioma resection sparing the dura
  • Subtotal meningioma resection
  • Surgical resection is not recommended among patients with asymptomatic stable meningioma.[1]
  • The Simpson criteria for meningioma correlates the degree of surgical resection completeness with the probability of post-surgical tumor recurrence:[1][2][3]
Simpson Grade Completeness of Resection 10-Year Recurrence
Grade 1
Complete removal including resection of underlying bone and associated dura

9%

Grade 2
Complete removal and coagulation of dural attachment

19%

Grade 3
Complete removal without resection of dura or coagulation

29%

Grade 4
Subtotal resection

40%

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 2015
  2. 2.0 2.1 2.2 Simpson grade. Radiopaedia(2015) http://radiopaedia.org/articles/simpson-grade Accessed on September, 25 2015
  3. 3.0 3.1 3.2 Simpson Grading System. Neurosurgic.com(2015) http://www.neurosurgic.com/index.php?option=com_content&view=article&id=846:simpson-grading-system-for-removal-of-meningeomas&catid=152:usefulinfo&Itemid=603 Accessed on September, 25 2015
  4. 4.0 4.1 4.2 Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF; et al. (2018). "Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy". Asian J Neurosurg. 13 (1): 86–89. doi:10.4103/1793-5482.181115. PMC 5820904. PMID 29492130.
  5. 5.0 5.1 Alexiou GA, Gogou P, Markoula S, Kyritsis AP (2010). "Management of meningiomas". Clin Neurol Neurosurg. 112 (3): 177–82. doi:10.1016/j.clineuro.2009.12.011. PMID 20056312.


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