Peritumoral brain edema in benign meningiomas: correlation with clinical, radiologic, and surgical factors and possible role on recurrence

• Published in: Surgical neurology 2008-11, Vol.70 (5), p.471-477
• Main Authors: Simis, Andre, MD, Pires de Aguiar, Paulo Henrique, PhD, Leite, Claudia C., PhD, Santana, Pedro Augustto, Rosemberg, Sergio, PhD, Teixeira, Manoel Jacobsen, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brain edema; Brain Edema - complications; Brain Edema - diagnosis; Brain Edema - surgery; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Meningeal Neoplasms - complications; Meningeal Neoplasms - pathology; Meningeal Neoplasms - surgery; Meningioma; Meningioma - complications; Meningioma - pathology; Meningioma - surgery; Middle Aged; Neoplasm Recurrence, Local - etiology; Neurology; Recurrence; Risk Factors; Simpson grade; Surgery; Treatment Outcome
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2008.03.006

Abstract Background Approximately 60% of meningiomas are associated with peritumoral edema. Various causative factors have been discussed in the literature. The objective of this study was to investigate the correlation of PTBE with clinical, radiologic, and surgical aspects and recurrence of meningiomas. Methods Sixty-one patients with benign meningiomas were chosen for surgical treatment by the Group of Brain Tumors and Metastasis of the Department of Neurosurgery. All patients underwent complete surgical resection (Simpson grades 1 and 2), and those with atypical and malignant histopathologic grades were excluded. Tumors located in the cavernous sinus, tuberculum sellae, foramen magnum, ventricles, and petroclival region were excluded. Results Edema extension had a positive correlation with the higher recurrence rates ( P = .042) and with the presence of irregular margins ( P < .011) on bivariate analysis. Meningiomas with larger edema sizes also showed correlation with large meningiomas ( P = .035), and the ones with smaller edema sizes correlated with the tentorial location ( P = .032). Multivariate analysis showed an association between PTBE and the presence of seizures (odds ratio, 3.469), large meningiomas (odds ratio, 15.977), and for each cubic centimeter added to its size, the risk of edema increased 1.082 times (odds ratio). Conclusion Peritumoral brain edema may be related to the invading potential of meningiomas and may play a role in the recurrence potential of the tumor. As a consequence, it is reasonable to consider the presence of edema as an additional factor to be taken into account when mapping out strategies for the treatment of meningiomas.