Clinical outcomes and survival analysis for petroclival meningioma patients receiving surgical resection: an analysis of 176 cases
Authors Qiao L, Yu C, Zhang H, Zhang M, Qu Y, Ren M, Gu C, Wang H
Received 9 January 2019
Accepted for publication 5 May 2019
Published 1 July 2019 Volume 2019:11 Pages 5949—5959
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Beicheng Sun
Li Qiao1,2, Chunjiang Yu,1 Hongwei Zhang,1 Mingshan Zhang,1 Yanming Qu,1 Ming Ren,1 Chunyu Gu,1 Haoran Wang1
1Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurosurgery, Gansu Provincial Hospital, Lanzhou, Gansu Province, People’s Republic of China
Purpose: The relationship of clinical results and survival analysis of operative patients with petroclival meningioma (PCM) was studied.
Patients and methods: Data from a total of 176 PCM patients receiving surgical resection were retrospectively collected. Follow-up was conducted through outpatient review by reexamination telephone calls and letters. Clinical outcomes, survival, and Karnofsky Performance Scale (KPS) data were analyzed.
Results: Seventy-two percent of patients (127/176) received only surgery, 8.5% (15/176) received surgery and adjuvant radiation therapy (RT) (surgery + RT), and 19.3% (34/176) received surgery and adjuvant gamma knife surgery (GKS) (surgery + GKS). Gross total resection (GTR) was performed in 34.7% of patients (61/176), subtotal resection (STR) in 58.0% (102/176), and partial resection (PR) in 7.4% (13/176). Recent follow-up KPS was higher than preoperative (80 vs 70, P<0.05) and postoperative KPS (80 vs 70, P<0.05). Cumulative survival was the same for 3, 5, 7, and 9 years, ie, 95%, and mean survival time (MST) was (110.83±2.55) months (95% CI: 105.83–115.83). Recurrence/progression (R/P)-free survival was 88.9%, 86.9%, 71.1% and 71.1%, respectively for 3, 5, 7, and 9 years, and MST was (100.58±3.82) months (95% CI: 93.11–108.06). R/P (HR: 5.486, 95% CI: 1.655–18.180), surgery + RT (HR: 0.125, 95% CI: 0.016–0.990) and WHO grade III (HR: 2.766, 95% CI: 1.146–6.676) were independently associated with cumulative survival. Lack of adhesion to and encasement of neurovascular structures was independently associated with R/P-free survival (HR: 2.002, 95% CI: 1.023–3.919).
Conclusion: Surgical treatment was safe and effective for PCM. R/P, surgery + RT, and WHO grade III were independently associated with cumulative survival. Lack of adhesion to and encasement of neurovascular structures was independently associated with R/P-free survival. These factors should be paid attention to in surgical treatment of PCM.
Keywords: petroclival meningiomas, resection, survival, radiation, therapy gamma knife surgery
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