Abstract
Objective: Tumor-associated proptosis comprises a frequent phenomenon that negatively impacts quality of life in patients suffering from spheno-orbital meningioma (SOM). Therefore, proptosis outcome represents an important measure in meningioma surgery. In the current study, we analyzed our institutional database in order to evaluate the recovery of tumor-associated proptosis in patients with SOM.Methods: Between 2009 and 2019, 32 patients with SOM underwent surgical treatment at the authors' institution. The exophthalmos index (EI) was calculated by means of preoperative and postoperative tumor-associated proptosis. Patients with preoperative EI ≥ 1.1 were included in further analysis. Further, we performed a systematic review of the contemporary literature. Favorable proptosis outcome was defined as postoperative decreased EI compared with preoperative EI.Results: Overall, 25 of 32 patients with SOM (78%) suffered from preoperative proptosis in the present series. Preoperative mean EI of 1.37 ± 0.18 decreased after surgical treatment to a postoperative mean EI of 1.15 ± 0.1 during follow-up (p < 0.0001). Systematic review of the literature revealed three studies with individual data on preoperative and postoperative EI measurements leading to a total of 103 patients; 100 of 103 patients (97%) with SOM and preoperative proptosis achieved favorable outcome.Conclusions: The EI provides a comparable standard in evaluation of surgical outcome in patients with tumor-associated proptosis due to SOMs. The large dataset consisting of pooled individual patient data from the systematic review of the literature and the present case series support the assumption that surgical treatment is highly effective in the treatment of tumor-associated proptosis in SOM.
Highlights
Tumor-associated proptosis is a typical presenting symptom in patients suffering from spheno-orbital meningiomas (SOMs) [1, 2]
The objective of the present study was to add comparable data on proptosis outcome after surgical treatment of SOM and to enable comparison by individual patient data extraction and pooling from a systematic review of the literature leading to the largest comparable dataset on proptosis in patients suffering from SOMs
Pertinent clinical information including age, sex, Karnofsky Performance Scale (KPS), tumor localization, tumor size, and presence of peritumoral edema, WHO grade referring to postoperative histological examination, extent of tumor resection according to the Simpson grading system, presence of preoperative visual symptoms, and presence and value of preoperative and postoperative proptosis were collected and entered into a computerized database (SPSS, version 25, IBM Corp., Armonk, NY)
Summary
Tumor-associated proptosis is a typical presenting symptom in patients suffering from spheno-orbital meningiomas (SOMs) [1, 2]. Standardized evaluation and comparability of initial characteristics and postoperative outcome of tumor-associated proptosis were cumbersome until the implementation of the exophthalmos index (EI) by Scarone et al in 2009 [1]. Patient data that enable a robust comparability of surgical results in the case of tumor-associated proptosis in patients with SOM are scarce.
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