Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

颅内脑膜瘤手术切除后,根据肿瘤位置评估术后出现功能障碍的风险

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Abstract

Object  Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery. Methods  Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location. Results  Postoperatively, from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (hazard ratio [HR] [95% confidence interval, CI] 3.000 [1.346-6.338], p  = 0.008), cerebellopontine angle tumors (HR [95% CI] 2.126 [1.094-3.947], p  = 0.03), Simpson grade 4 resections (HR [95% CI] 2.000 [1.271-3.127], p  = 0.003), preoperative motor deficits (HR [95% CI] 1.738 [1.005-2.923], p  = 0.048), preoperative cognitive deficits (HR [95% CI] 2.033 [1.144-3.504], p  = 0.02), and perioperative pulmonary embolisms (HR [95% CI] 11.741 [2.803-59.314], p  = 0.0009). Conclusion  Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

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