Mustafa GÜDÜK, Baran BOZKURT, Murat Şakir EKŞİ, Murat İmre USSELİ, Mustafa Necmettin PAMİR

Derece II ve III meningiomların preoperatif prediktif faktörleri

Amaç:Meningiomlar en sık görülen primer intrakranyal patolojilerdir. Patolojik olarak üç dereceleri vardır. Cerrahi ile total rezeksiyon belirleyici tedavi olmakla beraber, özellikle asemptomatik ve insidental vakalarda, yakın takip veya stereotaktik radyocerrahi tercih edilebilmektedir. Cerrahi tedavi ile konservatif tedavi arasında karar verebilmek açısından, daha agresif klinik seyir gösterebilen Derece II ve III meningiomların, ön görülebilmesi önem taşımaktadır. Çalışmamızda, meningiom serimizde kayıtlı hastaların klinik, radyolojik ve yerleşim özelliklerine göre patolojik derecelerinde prediktif olabilecek etkenleri araştırdık. Hastalar ve Yöntem:İntrakranyal meningiom veri tabanımıza kayıtlı, Eylül 1986 ile Temmuz 2019 arasında opere edilen hastaların klinik, radyolojik, cerrahi ve patolojik raporları retrospektif olarak tarandı. Yaş, cinsiyet, tümör yerleşimi, peritümöral ödem olup olmaması, patolojik derecesi not edildi. Patoloji dereceleri açısından yaşın, cinsiyetin, ödemin ve tümör yerleşiminin prediktif olup olmadığı istatistiki yöntemler ile araştırıldı. Bulgular:Veri tabanımızda 1401 intrakranyal meningiom hastası tespit edildi. Hastaların 1015’i kadın, 386’sı erkekti (kadın/erkek=2,6). Ortalama yaşları 52,2 yıl idi. Bin iki yüz on dokuz Derece I, 164 Derece II, 18 Derece III meningiom vardı. Erkek cinsiyeti ve/veya kafa tabanı dışı yerleşim Derece II ve III meningiomlar için prediktif olarak tespit edildi. Sonuç:Asemptomatik, insidental olarak tespit edilen meningiomlarda, konservatif tedavi (yakın takip veya stereotaktik radyocerrahi) tercih edildiğinde, erkek ve/veya kafa tabanı dışı yerleşimli olanların, daha agresif davranışlı olan Derece II veya III olma ihtimalinin daha yüksek olduğu unutulmamalıdır.

Pre-operative predictive factors of grade II and III meningiomas

Purpose:Meningiomas are the most common primary intracranial tumors. They are graded into three pathologic grades. Surgical gross total resection is the definitive treatment of meningiomas, but follow-up or stereotactic radiosurgery is sometimes advised for asymptomatic, incidentally diagnosed meningiomas. For a decision making, pre-operative prediction of Grade II and III meningiomas which are more aggressive clinically, is important. We have reviewed our intracranial meningioma series, based on their clinical, radiological, and location, to analyze the predictive factors of Grade II and III meningiomas. Patients and Methods:The clinical, radiological, operative and pathological reports of patients who were operated for intracranial meningiomas between September 1986 and July 2019 have been reviewed retrospectively from our patient database. Their age, sex, tumor location, absence or presence of peritumoral edema, and the pathological grade of meningiomas have been noted. The predictive effect of age, sex, peritumoral edema and location of tumor is analyzed statistically for pathological grade. Results:There were 1401 patients with intracranial meningiomas, 1015 of them were female, 386 were male (female/male=2.6). Their mean age was 52.2 years. There were 1219 Grade I, 164 Grade II, and 18 Grade III meningiomas. Male sex, and non-skull base location were predictive for Grade II and III meningiomas. Conclusion:While advising conservative treatment (follow-up, or stereotactic radiosurgery) for asymptomatic, incidental meningiomas, it should be kept in mind that male sex, and/or non-skull base location are risk factors for the more aggressive Grade II and III meningiomas.

Keywords:

meningiomas, grade II meningiomas, grade III meningiomas,

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