Factors Influencing the Outcome of Patients with Surgically Managed Intracranial Meningioma

Abstract

Background: Intracranial Meningiomas are the most common primary brain tumor in  adult which are predominantly non-malignant. Surgical intervention is the goldstandard  treatment option for intracranial meningiomas but the surgical outcomes are  influenced by various epidemiological risk factors. Understanding these factors is  essential for a precise decision-making process, application of effective therapeutic  intervention and prognostication.  Aims: This study aimed to identify the possible predictive factors influencing surgical  outcome in patients with intracranial meningioma.  Materials and Methods: This Prospective Observational Study included 34 patients  of intracranial Meningioma who had surgery in the Department of Neurosurgery,  Chittagong Medical College Hospital between February 2022 to August 2023. Outcome  measures were the Glasgow Outcome Scale (GOS) and Karnofsky Performance Status  (KPS) score at the immediate postoperative period, “0” postoperative day, at the time  of discharge, 1 month, 3 months, and 6 months post-surgery. GOS score 1-3 was  considered as poor outcome.  Results: The mean age of the patients was 46.8±12.6 years and 70.6% were female.  Most of the patients were in either ASA class I (35.3%) or Class II (55.9%), and the  median KPS score was 80% before surgery. Twenty-eight (82.4%) patients survived  at least six months following surgery and the 6-months mortality rate was 17.6%.  Twenty-seven (79.4%) patients had a good outcome and 7 (20.6%) patients had a  poor outcome. Preoperative KPS score (p=0.024), tumor location (p=0.019), and tumor  volume (p=0.003) were found to have a significant association with outcome in  univariate analysis. However, none of these factors retained a significant association  in multivariate analysis.  Conclusions: In conclusion, specific influencing factors for postoperative poor  outcomes revealed in univariate analysis in the present study were low preoperative  KPS score, skull base meningioma, and large-size tumor 

Bang. J Neurosurgery 2024; 13(2): 121-129