Clinical and radiological predictors of recurrence following meningioma surgery

Abstract

Background:Meningiomas are common intracranial tumours with generally favourable outcomes; however, postoperative recurrence remains an important clinical problem. Identification of clinical and radiological factors associated with recurrence may improve postoperative risk stratification and surveillance.Objective:To evaluate the clinical and radiological predictors of recurrence following surgical resection of intracranial meningiomas. Methods:

This retrospective observational study included 218 consecutive patients with histopathologically confirmed intracranial meningiomas who underwent surgical resection. Demographic, clinical, radiological, histopathological, and surgical variables were recorded. Radiological parameters included tumour location, size, volume, peritumoral oedema, contrast-enhancement pattern, and postoperative residual tumour. Extent of resection was classified according to the Simpson grading system. Patients were followed clinically and radiologically for evidence of recurrence. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of recurrence. Kaplan–Meier and Cox regression analyses were used for recurrence-free survival.Results:The study population comprised 72 (33.0%) males and 146 (67.0%) females, with a mean age of 48.6 ± 12.7 years. WHO grade 1 tumours constituted 80.7% of cases. Gross/near-total resection (Simpson grades I–II) was achieved in 74.8%. During a median follow-up of 48 months, 33 patients (15.1%) developed recurrence. Recurrence was significantly associated with tumour volume >40 cm³, peritumoral oedema, higher WHO grade, Simpson grade III–IV resection, and postoperative residual tumour. On multivariable analysis, these factors remained independent predictors of recurrence.Conclusion:Recurrence following meningioma surgery is influenced by tumour biology, radiological characteristics, and extent of resection. Postoperative residual tumour, higher WHO grade, larger tumour volume, peritumoral oedema, and incomplete resection may help identify patients requiring closer and prolonged postoperative surveillance.