Clinical Profile of Tuberculum Sellae Meningiomas Based on Scoring System: An Institutional Experience in Indonesia.

Tuberculum sellae meningioma (TSM) is a challenging tumor that grows close to several crucial structures, such as the optic nerve, arteries, and pituitary. Surgical treatment is currently evolving from a transcranial microsurgical resection to a transsphenoidal approach. This study examined the clinical profile of patients with tuberculum sellae meningioma and explored its relationship with scoring systems. This retrospective observational study included patients with TSM who underwent surgery at the Department of Neurosurgery at our hospital between 2017 and 2022. The patients were excluded if their data required completion. The clinical profiles of the patients were counted and transformed into a scoring system using several variables such as size, vascular, and canal invasion. We then analyzed the relationship between the clinical signs and symptoms to determine the efficacy of this scoring system. Thirty-six patients were included in the study. Most of our patients had a high score for tumor diameter, bilateral canal invasion, and vascular invasion (2-2-2). Moreover, when related to clinical signs, there was no relationship between the canal and vascular invasion and decreased visual acuity. Tuberculum sellae meningioma mostly causes visual impairment and several other symptoms, such as hemianopsia and parasellar extension. Several factors in the scoring system should also be considered to predict outcomes, such as the onset of visual symptoms, peritumoral edema, and grade of excision.

Hearing Preservation, Facial Nerve Dysfunction, and Tumor Control in Small Vestibular Schwannoma: A Systematic Review of Gamma Knife Radiosurgery Versus Microsurgery.

BACKGROUND AND PURPOSE: Vestibular schwannoma (VS) is the most common type of tumor found in the cerebellopontine angle that accounts for 8% of all intracranial tumors. VS management is currently a challenge due to the unpredictable nature of the tumor. Few studies have compared the results and complications of various therapeutic approaches to VS. Therefore, as a treatment option for VSs smaller than 25 mm, we conducted a systematic review to compare Gamma Knife radiosurgery (GKRS) with conventional surgery. METHODS: Literature searches were conducted of four online databases (PubMed, Google Scholar, Cochrane, and ScienceDirect) using the following keyword search: ("vestibular schwannoma" OR "acoustic neuroma") AND ("gamma knife" OR "gamma knife radiosurgery") AND ("resection" OR "open surgery") AND ("hearing preservation" OR "facial nerve" OR "tumor growth"). RESULTS: We identified six retrospective cohort studies, five of which were of fair-to-good quality. All studies showed that GKRS was superior to surgery in hearing preservation. Two studies indicated that surgery was superior to GKRS in maintaining tumor control, one indicated that GKRS was superior, and the remainder indicated that there was no significant difference in maintaining tumor control between GKRS and microsurgery. CONCLUSIONS: Based on the three outcomes chosen for this review, GKRS was superior to microsurgery in small VS.

Overexpression of c-Met is Associated with Poor Prognosis in Glioblastoma Multiforme: A Systematic Review and Meta-Analyses.

OBJECTIVE: The aim of this study is to evaluate the association of c-Met overexpression with survival of glioblastoma multiforme (GBM) patients. METHODS: A systematic review with meta-analyses was conducted on related articles from PubMed, EBSCOhost, Scopus, and Cochrane databases with last updated search on October 31, 2020. A total of 7 studies regarding c-Met overexpression and overall survival (OS) and/or progression free survival (PFS) are included in this study. RESULTS: All studies used immunohistochemistry to examine the expression of c-Met protein. The results showed that the positive rate of c-Met overexpression was detected in approximately 33,9% - 60,5% of GBM patients. c-Met overexpression was related to worse OS (HR: 1,74; 95% CI: 1,482-2,043; Z=6,756; p<0,001) and PFS (HR: 1,66; 95% CI: 1,327-2,066; Z=4,464; p<0,001) in GBM patients. Low heterogeneity of subjects was found in both OS and PFS analyses, I2 values were 7,8% and 0,0%, respectively. CONCLUSION: In conclusion, c-Met overexpression is significantly related to shorter OS and PFS in GBM patients, so c-Met can be considered as a potential prognostic indicator in GBM.

Pre-and Post-Surgical Health-Related Quality of Life Evaluation of Spheno-orbital Meningioma Patients Based on EORTC QLQ-C30 Questionnaire at Dr. Cipto Mangunkusumo General Hospital.

OBJECTIVE: Health-related quality of life (HRQoL) has become an important outcome for neurosurgical patients underwent surgery. The authors utilized the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ C-30) to assess the quality of life of spheno-orbital meningiomas patients after surgery in one national central referral hospital in Indonesia. METHODS: In this cross-sectional study, medical record-based data of 40 spheno-orbital meningioma patients who underwent surgery at Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia from October-December 2016 were analyzed. Differences between pre-and postsurgical EORTC scores was examined using the Student's t test. RESULTS: There was a statistically significant increase of EORTC QLQ-C30 scores in global health status, role functioning, emotional functioning, cognitive functioning, and social functioning variables, and statistically significant decrease for clinical symptoms variables. CONCLUSION: Evidently, there was improvement in HRQoL in spheno-orbital meningiomas patients after surgery, in whom EORTC QLQ-C30 can be used to assess the HRQoL prior to and after surgical procedures.