06Jan 2018

THE NATURAL COURSE OF INCIDENTAL INTRACRANIAL MENINGIOMAS: SYSTEMATIC REVIEW AND META-ANALYSIS.

  • Department of Neurosurgery, Benha University.
  • Department of Public Health & Community Medicine, Benha University.
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Background: With the increasing availability of radiological imaging, detection of incidental intracranial meningiomas in asymptomatic patients has increased dramatically. The best management of incidentally found meningiomas is not as clear. A systematic review and meta-analysis of the studies currently available allows for a better understanding of the natural course of asymptomatic meningiomas, a platform for more research, and a foundation on which a standardized guideline for following these tumors may be built. Methods: A systematic review of the English language literature published before October 2017 with no lower date limit was carried out. Data collected from the articles included years of the study, study location, study design, number of patients with asymptomatic meningiomas with follow-up, number of meningiomas, inclusion of NF2 patients, mean age, gender, whether tumor was defined as growing or not, tumor location, MRI characteristics, initial size of the tumors, growth rates, and outcome of follow-up. Meta-analysis of the collected data was carried out. Results: Twenty studies were identified and included in the meta-analysis (1108 patients, 1175 meningiomas). Meta-analysis results revealed an inverse relationship between age of patients and tumor growth (P<0.001). There was no significant correlation between tumor growth and gender (P=0.15). The presence of calcification was associated with significant reduced risk of growth (P<0.001). Meanwhile, growth was associated with the presence of edema (P=0.005) and T2 hyperintensity (P<0.001). Also, the tumor growth was associated with initial tumor size P=0.01. The outcome of follow up for 1154 tumors in all included studies revealed that 551 (47.7%) had grown, 283(51.4%) of them grown asymptomatically and 153 (27.8%) underwent surgery. 149 out of 1093 patients in the whole analysis developed symptoms during their follow-up (13.6%). The mean follow-up duration for the whole analysis was 60.7 months. Conclusion: Regarding incidentally discovered meningiomas, an initial follow-up within 3-6 months of initial diagnosis with both clinical and radiological exam followed by another exam at 9-12 months. After the initial observation period, annual radiological exams may be sufficient with special consideration between years 5-10 post-diagnosis.

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[Mohammed Hammad Eltantawy, Ahmed Mohamed Nabeel and Hanaa Bayomy. (2018); THE NATURAL COURSE OF INCIDENTAL INTRACRANIAL MENINGIOMAS: SYSTEMATIC REVIEW AND META-ANALYSIS. Int. J. of Adv. Res. 6 (Jan). 530-545] (ISSN 2320-5407). www.journalijar.com

Mohammed Hammad Eltantawy

DOI:

Article DOI: 10.21474/IJAR01/6253      
DOI URL: https://dx.doi.org/10.21474/IJAR01/6253

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