Abstract
OBJECTIVE: The benefit of the current strategy for diagnosis (computer tomography and magnetic resonance imagine) and treatment (microsurgery, microscope, endoscope) of meningiomas, in contrast to the standard treatment in use before CT- and MR-imaging and the microsurgical era, has not yet been determined. METHODS: A retrospective statistical analysis was performed for 1349 meningioma patients who underwent surgery at the Neurosurgical Department of the Saarland University between 1965 and 2011. The patients who underwent surgery before 1985 were compared to the second group of patients who underwent surgery of meningiomas after 1985. We selected 1985 as point of time because the CT scan was available since this time in our department. RESULTS: There were no major differences in tumor localization, tumor size, gender, initial symptomatology and number of surgical procedures in both groups. The mean time until tumor diagnosis was shorter in the meningioma group after 1985. Number of perioperative complications were similar in both groups (18% vs 16%). A significant better prognosis for patients operated after 1985 with regard to the postoperative duration of recurrence free survival could be revealed (p < 0.0001). However, the overall survival remained unchanged. DISCUSSION: Based on the results of this study, the overall prognosis for patients with meningiomas has changed from the 1960s until today with a prolonged progression free survival in the last two decades. Also mean time to diagnosis has been remarkable reduced over decades. Thus, the introduction of modern diagnostic modalities and surgical procedures has improved the outcome in patients with meningiomas significantly.