Clinical outcomes and survival analysis for petroclival meningioma patients receiving surgical resection: an analysis of 176 cases

• Main Authors: Qiao L, Yu C, Zhang H, Zhang M, Qu Y, Ren M, Gu C, Wang H
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-07-01
• Series: Cancer Management and Research
• Subjects: Petroclival meningiomas; Resection; Survival; Radiation therapy; Gamma knife surgery
• Online Access: https://www.dovepress.com/clinical-outcomes-and-survival-analysis-for-petroclival-meningioma-pat-peer-reviewed-article-CMAR

Li Qiao1,2, Chunjiang Yu,1 Hongwei Zhang,1 Mingshan Zhang,1 Yanming Qu,1 Ming Ren,1 Chunyu Gu,1 Haoran Wang11Department 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 ChinaPurpose: 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