Stereotactic radiosurgery versus active surveillance for asymptomatic, skull-based meningiomas: an international, multicenter matched cohort study

Objective The optimal management of asymptomatic, skull-based meningiomas is not well defined. The aim of this study is to compare the imaging and clinical outcomes of patients with asymptomatic, skull-based meningiomas managed either with upfront stereotactic radiosurgery (SRS) or active surveillan...

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Published in:Journal of neuro-oncology 2022-02, Vol.156 (3), p.509-518
Main Authors: Mantziaris, Georgios, Pikis, Stylianos, Samanci, Yavuz, Peker, Selcuk, Nabeel, Ahmed M., Reda, Wael A., Tawadros, Sameh R., El-Shehaby, Amr M. N., Abdelkarim, Khaled, Emad, Reem M., Delabar, Violaine, Mathieu, David, Lee, Cheng-chia, Yang, Huai-che, Liscak, Roman, Hanuska, Jaromir, Alvarez, Roberto Martinez, Moreno, Nuria Martinez, Tripathi, Manjul, Speckter, Herwin, Albert, Camilo, Benveniste, Ronald J., Bowden, Greg N., Patel, Dev N., Kondziolka, Douglas, Bernstein, Kenneth, Lunsford, L. Dade, Jenkinson, Michael D., Islim, Abdurrahman I., Sheehan, Jason
Format: Article
Language:English
Subjects:
Asymptomatic
Brain cancer
Clinical Study
Cohort analysis
Health surveillance
Humans
Medicine
Medicine & Public Health
Meningioma
Meningioma - pathology
Meningioma - radiotherapy
Morbidity
Neurological diseases
Neurology
Oncology
Patients
Radiosurgery
Radiosurgery - methods
Retrospective Studies
Skull
Skull Base Neoplasms - pathology
Skull Base Neoplasms - radiotherapy
Treatment Outcome
Tumors
Watchful Waiting
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Summary:Objective The optimal management of asymptomatic, skull-based meningiomas is not well defined. The aim of this study is to compare the imaging and clinical outcomes of patients with asymptomatic, skull-based meningiomas managed either with upfront stereotactic radiosurgery (SRS) or active surveillance. Methods This retrospective, multicenter study involved patients with asymptomatic, skull-based meningiomas. The study end-points included local tumor control and the development of new neurological deficits attributable to the tumor. Factors associated with tumor progression and neurological morbidity were also analyzed. Results The combined unmatched cohort included 417 patients. Following propensity score matching for age, tumor volume, and follow-up 110 patients remained in each cohort. Tumor control was achieved in 98.2% and 61.8% of the SRS and active surveillance cohorts, respectively. SRS was associated with superior local tumor control (p 
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-021-03923-3