The dural attachment length predict prognosis in patients with recurrent meningiomas.

Abstract

To investigate the prognostic factors of recurrent meningioma patients who underwent reoperation, so as to make relevant recommendations for the treatment. A retrospective analysis was performed on 73 patients with recurrent meningioma. Patients' clinical data were obtained from their medical records. Progression-free Survival (PFS) was defined as the interval from the date of surgery to the date of tumor recurrence, or to the date of the last imaging review. Overall survival (OS) was defined as the time from the date of surgery to death from any cause, or to the date of the last follow-up. The multivariate COX regression showed that dural attachment length (HR = 1.238, 95%CI1.011-1.516, P = 0.039) and WHO grade (HR = 2.184, 95%CI1.135-4.203, P = 0.019) were independent risk factors for tumor progression. The factors associated with survival in multivariate regression analysis were preoperative Karnofsky Performance Scale (KPS) (HR = 0.951, 95%CI0.923-0.979, P = 0.001), dural attachment length (HR = 1.520, 95%CI1.124-2.057, P = 0.007) and WHO grade (HR = 4.829, 95%CI1.891-12.331, P = 0.001). The dural attachment length (OR = 1.843, 95%CI1.236-2.748, P = 0.003) was the only risk factor associated with postoperative pulmonary infection. No correlation was observed between Simpson's grade and either PFS or OS. The dural attachment length is closely related to the prognosis of recurrent meningioma, which should be given importance during the perioperative assessment.