Intracranial Meningiomas: Treatment and Quality of Life

Abstract

Results of surgery of intracranial meningiomas are affected by location, size, histological attributes and genetic alterations of the tumors. Operative morbidity and mortality have traditionally been used to describe outcome after meningioma surgery. Yet, according to current outcomes research programs, assessment of a broad spectrum of parameters, including quality of life (QOL) indices is required to adequately reflect the results of a given treatment. An evaluation using a combination of neuropsychological tests and a structured interview was suggested to enable a comparison of both objective and subjective aspects of the complex construct QOL. Until now few information about the different aspects of QOL after meningioma surgery is available. Yet, it was shown that surgeons’ assessments tend to suggest a favorable outcome, in-depth investigations of the patients’ perspectives clearly showed their QOL to be adversely affected. Most of younger patients were not satisfied with life and reported a strong feeling not to be accepted in society, resulting in lowered self-confidence and general performance. It was concluded that a comprehensive evaluation after meningioma surgery is required to prevent poor long-term results after apparently successful surgery. Consideration of tumor attributes and an understanding of relevant outcome and its effect upon the patient’s life are essential for a deliberate decision whether surgery is clearly indicated or another treatment should be preferred.