TY - JOUR
T1 - Adjuvant Radiosurgery Versus Serial Surveillance Following Subtotal Resection of Atypical Meningioma
T2 - A Systematic Analysis
AU - Lagman, Carlito
AU - Bhatt, Nikhilesh S.
AU - Lee, Seung J.
AU - Bui, Timothy T.
AU - Chung, Lawrance K.
AU - Voth, Brittany L.
AU - Barnette, Natalie E.
AU - Pouratian, Nader
AU - Lee, Percy
AU - Selch, Michael
AU - Kaprealian, Tania
AU - Chin, Robert
AU - McArthur, David L.
AU - Mukherjee, Debraj
AU - Patil, Chirag G.
AU - Yang, Isaac
N1 - Funding Information:
Conflict of interest statement: C.L. was partially supported by a Gurtin Skull Base Research Fellowship. L.K.C. was partially supported by an American Medical Association Foundation Seed Grant and an AΩA Carolyn L. Kuckein Student Research Fellowship. I.Y. was partially supported by a Visionary Fund Grant, an Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research UCLA Scholars in Translational Medicine Program Award, a Jason Dessel Memorial Seed Grant, a UCLA Honberger Endowment Brain Tumor Research Seed Grant, and a Stop Cancer (US) Research Career Development Award.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background Atypical meningioma (AM) is an aggressive subtype of meningioma associated with a high recurrence rates (RR) following surgical resection. Recent studies have compared outcomes of various treatment strategies, but advantages of adjuvant radiosurgery (ARS) over serial surveillance (SS) following subtotal resection (STR) remain unclear. To further elucidate this issue, we systematically analyzed the current literature on AM and compared outcomes of ARS versus SS after STR. Methods Embase, PubMed, and Cochrane databases were queried using relevant search terms. Retrospective case series that described patients with AM treated with ARS and SS after STR were included. Tests of proportions were performed to detect significant variations in RR, 5-year progression-free survival (PFS), and 5-year overall survival (OS) between the treatment strategies (ARS vs. SS) and among individual studies. Results A total of 619 patients (263 in the ARS group and 356 in the SS group) were identified. Mean RR, 5-year PFS, and 5-year OS were 53.5%, 50.3%, and 74.9%, respectively, for ARS versus 89.8%, 19.1%, and 89.8% for SS. RR differed between treatment strategies and ARS studies (P < 0.001), and 5-year PFS differed among treatment strategies, ARS, and SS studies (P < 0.001, P = 0.007, and P < 0.001, respectively). Conclusions The data presented here show significant differences in RR and 5-year PFS between ARS and SS, suggesting a potential benefit of ARS. As our understanding of the clinical outcomes of various treatment strategies for AM increases, we also move closer to integrating modalities, such as radiosurgery, into management guidelines.
AB - Background Atypical meningioma (AM) is an aggressive subtype of meningioma associated with a high recurrence rates (RR) following surgical resection. Recent studies have compared outcomes of various treatment strategies, but advantages of adjuvant radiosurgery (ARS) over serial surveillance (SS) following subtotal resection (STR) remain unclear. To further elucidate this issue, we systematically analyzed the current literature on AM and compared outcomes of ARS versus SS after STR. Methods Embase, PubMed, and Cochrane databases were queried using relevant search terms. Retrospective case series that described patients with AM treated with ARS and SS after STR were included. Tests of proportions were performed to detect significant variations in RR, 5-year progression-free survival (PFS), and 5-year overall survival (OS) between the treatment strategies (ARS vs. SS) and among individual studies. Results A total of 619 patients (263 in the ARS group and 356 in the SS group) were identified. Mean RR, 5-year PFS, and 5-year OS were 53.5%, 50.3%, and 74.9%, respectively, for ARS versus 89.8%, 19.1%, and 89.8% for SS. RR differed between treatment strategies and ARS studies (P < 0.001), and 5-year PFS differed among treatment strategies, ARS, and SS studies (P < 0.001, P = 0.007, and P < 0.001, respectively). Conclusions The data presented here show significant differences in RR and 5-year PFS between ARS and SS, suggesting a potential benefit of ARS. As our understanding of the clinical outcomes of various treatment strategies for AM increases, we also move closer to integrating modalities, such as radiosurgery, into management guidelines.
KW - Adjuvant radiosurgery
KW - Atypical meningioma
KW - Serial surveillance
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U2 - 10.1016/j.wneu.2016.11.021
DO - 10.1016/j.wneu.2016.11.021
M3 - Article
C2 - 27856384
AN - SCOPUS:85002376157
SN - 1878-8750
VL - 98
SP - 339
EP - 346
JO - World neurosurgery
JF - World neurosurgery
ER -