Evaluating Minimally Invasive Approaches to Meningioma Treatment (P4-5.026).

in Neurology by Varun Rachakonda, Anuttham Kandhadai, Paul Brindley

TLDR

  • A retrospective cohort study found that stereotactic radiosurgery (SRS) may be associated with lower mortality rates, decreased risks of malignant neoplasms, and improved short-term outcomes compared to surgical resection in treating meningiomas.
  • Key Insights: SRS may be a more effective treatment option for meningiomas, with potential benefits including reduced mortality, decreased risk of malignant neoplasms, and improved short-term outcomes.

Abstract

To investigate the differences in outcomes of stereotactic radiosurgery in comparison to traditional surgical resection in the management of meningiomas. Meningiomas present complex therapeutic challenges due to their potential impact on neurological function and quality of life. While the standard of care involves observation and surgical resection, stereotactic radiosurgery (SRS) has emerged as an alternative treatment modality. This study aimed to compare the relative efficacy of SRS and surgical resection in the management of meningiomas to inform evidence-based decision-making in this clinical context. A retrospective cohort study was conducted using the TriNetX database, comparing patients undergoing treatment for meningiomas with either stereotactic radiosurgery (SRS) or surgical resection. Cohorts were matched on comorbidities. Rates of mortality and malignant neoplasms of the brain within 5-years of treatment with either modality was compared. In addition, short-term outcomes were assessed at 3 months post-treatment. After matching, there were 1,898 patients in each cohort. Patients receiving SRS exhibited a significantly lower risk of mortality (95% CI: 0.76-1.07) and a decreased risk of developing malignant neoplasms of the brain (RR: 0.68, 95% CI: 0.54-0.85) over 5 years, compared to surgical resection. At 3-months post treatment, patients treated with SRS demonstrated significantly lower relative risks for several outcomes, including cerebral infarction (RR: 0.27, 95% CI: 0.18-0.39), hydrocephalus (RR: 0.19, 95% CI: 0.11-0.32), cerebral edema (RR: 0.13, 95% CI: 0.10-0.18), seizures (RR: 0.27, 95% CI: 0.21-0.34), neurological deficits (RR: 0.19, 95% CI: 0.13-0.28), and post-procedural infection (RR: 0.14, 95% CI: 0.07-0.28). This retrospective cohort study suggests that in the management of meningiomas, SRS may be associated with lower mortality rates, decreased risks of malignant neoplasms of the brain, and improved short-term outcomes compared to surgical resection. Further research is warranted to validate these results and explore long-term outcomes and potential adverse effects.Mr. Rachakonda has nothing to disclose. Mr. Kandhadai has nothing to disclose. Dr. Brindley has nothing to disclose.

Overview

  • The study aimed to compare the effectiveness of stereotactic radiosurgery (SRS) and surgical resection in treating meningiomas, a complex and challenging type of brain tumor.
  • A retrospective cohort study was conducted using the TriNetX database, matching patients who received either SRS or surgical resection based on comorbidities.
  • The study aimed to identify the best treatment option for meningiomas, considering mortality rates, risks of malignant neoplasms, and short-term outcomes.

Comparative Analysis & Findings

  • The study found that patients who received SRS had a significantly lower risk of mortality and malignant neoplasms of the brain compared to those who underwent surgical resection.
  • SRS was associated with improved short-term outcomes, including lower relative risks for cerebral infarction, hydrocephalus, cerebral edema, seizures, neurological deficits, and post-procedural infection.
  • The results suggest that SRS may be a more effective treatment option for meningiomas, but the study emphasizes the need for further research to validate the findings and explore long-term outcomes.

Implications and Future Directions

  • The study's findings have significant implications for the management of meningiomas, suggesting that SRS may be a viable alternative to traditional surgical resection.
  • Future research should aim to validate the results and explore long-term outcomes, as well as examine potential adverse effects and treatment strategies.
  • The study's findings may also inform the development of evidence-based treatment guidelines for meningiomas and improve patient outcomes.
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