Growth dynamics of incidental meningiomas: A prospective long-term follow-up study.
Neurooncol Pract
; 10(3): 238-248, 2023 Jun.
Article
in En
| MEDLINE
| ID: mdl-37188168
ABSTRACT
Background:
There is no consensus on the management of incidental meningiomas. The literature on long-term growth dynamics is sparse and the natural history of these tumors remains to be illuminated.Methods:
We prospectively assessed long-term tumor growth dynamics and survival rates during active monitoring of 62 patients (45 female, mean age 63.9 years) harboring 68 tumors. Clinical and radiological data were obtained every 6 months for 2 years, annually until 5 years, then every second year.Results:
The natural progression of incidental meningiomas during 12 years of monitoring was growth (Pâ <â .001). However, mean growth decelerated at 1.5 years and became insignificant after 8 years. Self-limiting growth patterns were seen in 43 (63.2%) tumors, non-decelerating in 20 (29.4%) and 5 (7.4%) were inconclusive due to â ≤â 2 measurements. Decelerating growth persisted once established. Within 5 years, 38 (97.4%) of 39 interventions were initiated. None developed symptoms prior to intervention. Large tumors (Pâ <â .001) involving venous sinuses (Pâ =â .039) grew most aggressively. Since inclusion 19 (30.6%) patients have died of unrelated causes and 2 (3%) from grade 2 meningiomas.Conclusion:
Active monitoring seems a safe and appropriate first-line management of incidental meningiomas. Intervention was avoided in â >â 40% with indolent tumors in this cohort. Treatment was not compromised by tumor growth. Clinical follow-up seems sufficient beyond 5 years if self-limiting growth is established. Steady or accelerating growth warrant monitoring until they reach a stable state or intervention is initiated.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Observational_studies
/
Prognostic_studies
Language:
En
Journal:
Neurooncol Pract
Year:
2023
Document type:
Article
Affiliation country:
Norway