MS-19 * LONG-TERM OUTCOMES FOR PATIENTS WITH INTRACRANIAL MENINGIOMAS: A SINGLE-INSTITUTION RETROSPECTIVE ANALYSIS

Abstract

While meningiomas represent the most common intracranial tumor, limited long-term outcome data are available. We analyzed clinical features and outcomes for all patients with intracranial meningiomas treated with radiotherapy at Duke University Medical Center between 1/1/1992 and 10/31/2013 by retrospective chart review. 237 patients were identified (median age 52; female:male 2:1); of these, 32 (14%) were diagnosed by imaging only. Median follow-up was 92 months (range 4-401) with follow-up >12 and 20 years for 88 and 22 patients, respectively. Histologic WHO grade distribution was 52% grade I, 15% grade II, 7% grade III, and 26% unknown. Patients received one or more of the following treatments: surgery (78%), stereotactic radiosurgery (26%), fractionated radiotherapy (84%), and/or systemic therapy (18%). Median overall survival (OS) and progression-free survival (PFS) were 383 and 113 months, respectively. Median OS was 389 months for grade I, 383 months for unknown grade, not reached for grade II, and 120 months for grade III (p 5%) was associated with shorter OS (median 174 months versus 383 months for grade I/unknown grade with low or unknown proliferation index). The median PFS for grade I, II, and III was 113, 45 and 39 months, respectively (p < 0.0001). 50% of patients (117) were treated for recurrent or progressive disease. Median OS after first treatment for recurrence was 327 months for grade I, not reached for grade II, 80 months for grade III, and 117 months for unknown grade (p = 0.003). Given the prolonged survival, frequent recurrences well past initial treatment, and the apparent efficacy of salvage therapy, meningioma patients should be observed systematically long after diagnosis.