Medical Student Jordan University of Science and Technology Jordan University of Science & Technology
Disclosure(s):
Khaled J. Zaitoun, MBBS: No financial relationships to disclose
Introduction: Spinal atypical meningiomas (SAM) represent a higher grade (WHO Grade II) subset of spinal meningiomas. The mainstay of treatment is surgical resection. Due to their rarity, postoperative management and prognosis remain poorly understood. The objective of this study is to investigate overall survival (OS) outcomes following surgery for SAMs, with a focus on the role of extent of resection and adjuvant therapies.
Methods: This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. We included adult patients (>18 years) who underwent surgical resection for SAMs. We reviewed demographic and clinical characteristics, extent of resection (gross total resection (GTR) versus subtotal resection (STR)), and adjuvant therapies. We performed multivariate Cox regression analysis to identify factors associated with OS.
Results: Overall, we included 93 patients who underwent surgical resection for SAMs. Fifty-eight of 93 (62.4%) patients were younger than 65 years, 62/93 (66.7%) were women. GTR was achieved in 24/93 (25.8%) of cases, and STR in the remaining 69/93 (74.2%). Mean follow up duration was 5 ±4 years. Six of 24 (25%) patients who had GTR and 9/69 (13%) patients who had STR underwent postoperative radiotherapy. Patients who had GTR, as compared with STR, were younger (GTR 79% < 65 years, versus STR 57% < 65 years, p=0.049), however there were no differences in other baseline characteristics. Multivariate analysis showed that male sex was associated with higher risk of mortality with adjusted hazard ratio (aHR) of 4.34 (95% CI: 1.56-12.08, p=0.005), and white patients with a lower risk of mortality with an aHR of 0.13 (95% CI: 0.04-0.46, p=0.002). There were no significant associations between age, tumor size, extent of resection, and postoperative radiation and the risk of mortality.
Conclusion : SAMs represent a minority of spinal meningiomas. In a nationwide administrative data sample, we found that factors associated with improved overall survival were female sex and white race. Younger age, tumor size, GTR, and postoperative radiation therapy were not significant predictors of OS.