Introduction: World Health Organization (WHO) Grade II meningiomas represent less than 10% of all meningiomas and tend to have higher recurrence rates. The aim of this study is to report on the management, prognostic factors, recurrence rates, and effect of radiotherapy on these tumours locally.
Methods: Retrospective chart review of 53 consecutive patients with a diagnosis of WHO Grade II meningiomas managed from June 2005 to December 2015. Data collected and analyzed included demographic profile, clinical characteristics, Karnofsky Performance Scale, tumor location and subtype, surgical management, follow-up and long-term outcomes.
Results: The M : F ratio was 1.8:1, with mean age of 44.9 ± 18.0 years. The duration of symptoms was 19.1 ± 32.5 months. Clinical presentation included headaches [42,80%], convulsions [19, 37%] and hemiparesis [18, 34%]. The meningiomas were located in the convexity [23, 43%] and skull base [15, 28%]. Simpsons Grade 1 and 2 resection was achieved in 33 (62.2%) cases while Grades 3 and 4 was achieved in six (11.3%) and 13 (4.5%) cases respectively. The histopathological subtypes were atypical [47, 88.6%], clear cell [2, 4%] and chordoid meningiomas [4, 8%]. One patient had metastases to the lung, while another underwent malignant transformation. Twenty-five patients (51%) received post-operative radiation at a mean dose of 49.7 ± 8.44 Gy. The follow-up period ranged from 3 to 108 months. The overall mortality was 22%.
Conclusions: Management of WHO grade II meningiomas involves aggressive surgical resection and post-operative radiotherapy in appropriately selected cases. Clinical and histopathological characteristics are also vital prognosticating tools for assessing outcomes of these tumours.
Patient Care: - The treatment of WHO Grade II meningiomas is targeted differenly in various neurosurgical centres, this study is aimed at influencing or validating the necessity of subjecting the patients to neoadjuvant therapy (radiotherapy).
- The upcoming statical analysis of this paper will shed more light to the above mentioned objectives
Learning Objectives: - To determine the factors affecting the outcome of meningiomas in a single neurosurgical centre, servicing a population of 10.5 million.
- To ascertain the value of post-surgical radiotherapy and the outcomes thereof
- To document factors associated with recurrence.