Abstract
ObjectiveSpheno-orbital meningiomas (SOM) are rare intracranial tumors that arise at the sphenoid wing. These tumors can invade important neurovascular structures making radical resection difficult, while residual tumors often lead to recurrence. The purpose of this study was to evaluate prognostic factors influencing the recurrence and progression-free survival (PFS) rates of spheno-orbital meningiomas, with a particular focus on the role of surgery and postoperative radiotherapy.MethodsBetween 2000 and March 2020, 65 cases of spheno-orbital meningioma were included, of which 50 cases underwent surgical treatment alone, and 15 cases underwent resection and radiotherapy. A Kaplan-Meier analysis was performed to provide median point estimates and PFS rates; further, Cox regression analysis was used to identify significant factors associated with treatment.ResultsGross total resection significantly reduced the risk of recurrence (p-value = 0.0062). There was no significant benefit for progression-free survival after postoperative radiotherapy (p-value = 0.42). Additionally, spheno-orbital meningiomas with an invasion of the cavernous sinus and intraconal invasion showed significantly worse PFS compared to other locations (p-value = 0.017).ConclusionThe maximal safe resection remains the most important prognostic factor associated with lower recurrence rates and longer PFS in patients with spheno-orbital meningioma. The invasion of the cavernous sinus and intraconal invasion was an independent factor associated with worse PFS. Patients with postoperative high-precision radiotherapy did not show significantly better PFS due to the small number of patients.
Highlights
Meningiomas are the most common benign intracranial tumors
A total of 69 patients with spheno-orbital meningioma were treated in our neurosurgical department between 2000 and 2020
gross total resection (GTR) was defined as Simpson grade I-III, which was achieved in 26 patients, of whom only one patient received a Simpson grade I resection
Summary
Meningiomas are the most common benign intracranial tumors. They account for approximately 12-15% of intracranial neoplasm [1]. Spheno-orbital meningioma (SOM) account for 2-9% of all intracranial meningioma [2]. They arise from the sphenoid wing and represent a unique category of invasive tumors characterized by pathological hyperostosis of the sphenoid bone. The invasion of the tumor bone together with its proximity to critical structures within the orbit, optic nerve canal, superior orbital fissure, and cavernous sinus lead to classic presentation of proptosis, deterioration of vision, abnormal eye movement, and headaches [3,4,5,6]
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