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DOI: 10.1055/s-0036-1592574
Early Surveillance Imaging after Complete Resection of Skull Base Meningiomas May Be Unnecessary
Objectives: Annual postoperative surveillance imaging has significant financial and logistical costs to patients and health care systems. We analyzed the clinical utility of surveillance imaging after the image-complete resection of WHO Grade I skull based meningiomas.
Methods: We conducted a retrospective cohort study of 64 patients who underwent image-complete resection of a skull based WHO Grade I meningioma at our institution between 2001 and 2013. All patients had a minimum of 2 years of postoperative follow-up. The period of follow-up was defined as the time between resection and last surveillance image. Outcomes measured included tumor recurrence, new tumor development, or other unexpected imaging finding.
Results: During an average follow-up period of 5.4 years (range: 2–13) the mean number of surveillance imaging studies performed per patient was 4.2 (range: 1–18). None of the patients in this study were found to have tumor recurrence or other unexpected abnormal findings on any surveillance imaging. One (2%) patient developed a second meningioma, found 13 years following resection of his initial skull based tumor.
Conclusion: Patients who have undergone an image-complete resection of a WHO Grade I skull based meningioma are at very low risk of early recurrence. Asymptomatic surveillance imaging during the first few years after resection has minimal clinical utility. It may be possible to reduce costs by formulating guidelines to limit unnecessary testing if these results are validated in other institutions.