Ionuț Cărăvan. 1, Iulia Maria Crișan. 1, Andreia Libenciuc

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Presentation transcript:

Post-operative complications in meningiomas involving major dural venous sinuses Ionuț Cărăvan *1, Iulia Maria Crișan *1, Andreia Libenciuc *1, Cristian Oancea *1 Scientific Coordinator: Prof. Ioan Ștefan Florian, M.D., Ph.D. *1, *2 *1 ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania *2 Neurosurgery Department of Cluj County Emergency Hospital

Background Meningiomas Post-operative complications Aim Benign tumors – arachnoid cap cells WHO classification*1 Post-operative complications MDVS invasion*2 Surgeon’s skills and experience Other factors Aim Analyze post-operative complications in meningiomas *1 Kleihues P, Louis DN, Scheithauer BW, et al. The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol. 2002 Mar;61(3):215–25. *2 Marcus DM, Aaron C, et al. Management of meningiomas involving the transverse or sigmoid sinus. Neurosurg Focus. 2013 Dec;35 (6):9-18.

Materials & Methods Single-center single-surgeon retrospective study 257 cases admitted between January 2008 and December 2013 Statistical analysis – EpiInfo software X2 test

Operative technique Localization/ MDVS involved Dural venous sinus handling *3 *3 Mathiesen T, Pettersson-Segerlind J, Kihlström L, et al. Meningiomas Engaging Major Venous Sinuses. World Neurosurg. 2014 Jan;81(1):116-24.

Results Age 15-85; mean=60 Sex distribution: 62% F; 38% M Histological Grades of Meningiomas Age 15-85; mean=60 Sex distribution: 62% F; 38% M

Results Post-operative complications: 23% (59 patients) Total recurrence rate: 18% (46 patients) Recurrence rate in meningioma invading SSS: 21,87%

Results MDVS Invasion: Post-operative complications: Higher WHO grade – OR 2,51 (CI 95% [0,98; 6,35], p= 0,03) Male patients – OR 2,79 (CI 95% [1,52; 5,11], p<0,001) Post-operative complications: Major dural venous sinuses invasion OR 2,3(CI 95% [1,21;4,41], p=0,01) Male patients - OR 1,68 (CI 95% [0,93;3,04], p=0,07) Higher WHO Grade OR 1,13 (CI 95% [0,38;3,23],p=0,8)

Discussions MDVS invasion meningiomas (OR=2,3) MDVS invasion – WHO II-III *4 Male gender meningiomas (OR=2,79) MDVS invasion meningiomas (OR=2,3) Complications in Higher WHO Grade meningiomas No significant tendency *4 Riemenschneider MJ, Perry A, Reifenberger G. Histological classification and molecular genetics of meningiomas. Lancet Neurol. 2006 Dec;5(12):1045-54.

Discussions Strong points Limits Large series of cases (257) Uniform series of cases 6 years (22% vs 11%) *5 Limits Retrospective study *5 Raza SM, Gallia GL, Brem H, et al. Perioperative and long-term outcomes from the management of parasagittal meningiomas invading the superior sagittal sinus. Neurosurgery. 2010 Oct;67:885–93.

Conclusions Major dural venous sinuses invasion Male patients Higher WHO Grade

Future development Prospective study

Thank you!