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Outcome determinant factors for patients treated surgically for intracranial and spinal meningiomas

Author: 
Youssef Boutros, Rabih Slim and El Murr Tony

Background: Meningiomas are a diverse set of tumors arising from the meninges (1). They account for one third of primary central nervous system tumors occurring primarily in older individuals with a female predominance (2). The etiology of meningiomas is not known in most cases (3). They can arise anywhere from the dura (4). Related Symptoms are determined by its location and by the time course over which the tumor develops (5,6).
In this study, we will classify our patients in different groups each one related to the surgical procedure used then classified into different subgroups to study survival among patients treated surgically for meningiomas.
Results: This was a retrospective cohort analysis done in two different medical centers on patients treated surgically for meningioma. Out of the 36 patients, pathologic studies revealed that 44% were transitional type, 31% meningothelial type, 8% atypical, 8% fibrous, 3% psammomatous, 3% anaplastic and one hemangiopericytoma grade 2/3. Regarding sex predilection, 67% of patients were female and 33% were male.
Concerning the Simpson grading system, it has been noted that the more aggressive in excising the tumor the less chance we have for tumor recurrence. The overall recurrence rate was higher among patients who underwent Simpson resection grade III and IV than those who underwent grade I and II.
Conclusion: Our study proves that anaplastic/atypical meningiomas carry out the highest risk of mortality and recurrence among other histological types and surgical treatment with extensive resection is the best treatment option in most of cases.
Moreover, our results showed that 86% of meningiomas are WHO grade I, 8% are grade II, and 3 % are grade III which is concordant also with the general statistics.

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