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J Neurol Surg B Skull Base 2021; 82(02): 208-215
DOI: 10.1055/s-0039-1697036
Original Article

Trends in the Management Paradigms of Intracranial Meningioma

Zaid Aljuboori 
1   Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Ahmad Alhourani
1   Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Shiao Woo
2   Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Eyas Hattab
3   Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Mehran Yusuf
2   Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Megan Nelson
4   Division of Physical and Medical Rehabilitation, Department of Neurological surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Norberto Andaluz
1   Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Dale Ding
1   Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
,
Jesse Savage
5   Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, United States
,
Brian Williams
1   Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States
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Abstract

Objective Intracranial meningiomas are the most common primary brain tumor. Treatment paradigms have evolved over time. There are limited number of population-based studies that examine this modern evolution. Here, we describe the trends of management of intracranial meningiomas using a national database.

Methods The data were obtained from the National Cancer Database for the years 2004 to 2015, the collected variables included: patients' age, gender, insurance type, income, comorbidity score, the tumor size and grade, and treatment modality (observation, surgery, radiotherapy, or combination therapy). We performed statistical analyses to detect association between unique variables and outcomes. In addition, we performed mortality analyses for various treatment modalities.

Results A total of 199,096 patients with a diagnosis of intracranial meningioma were included, the majority of patients were white females, mean age of 61 years, and half of the tumors were ≤ 3 cm. Observation was the most commonly used management modality followed by surgical resection, radiotherapy, and combination therapy. For the entire time period, there was an increased use of observation as a primary management method. Predictors of mortality included increased age, larger tumor size, higher tumor grade, treatment at a community hospital, and higher comorbidity scores.

Conclusion Population-based studies of intracranial meningiomas are uncommon; our study is one of the few reports that examine the changes in the modern management paradigms of meningioma in the United States over time. Additionally, we shed light on the factors that affected survival of patients with this condition.

Keywords

brain tumor - meningioma - surgery - radiotherapy - observation - database

Disclosure

Brian J. Williams is a consultant at Monteris Medical.




Publication History

Received: 22 March 2019

Accepted: 11 August 2019

Article published online:
17 September 2019

© 2019. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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