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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 25, No. 3, 2018, pp. 88-102
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Bioline Code: mj18037
Full paper language: English
Document type: Research Article
Document available free of charge
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Malaysian Journal of Medical Sciences, Vol. 25, No. 3, 2018, pp. 88-102
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Incidence, Clinico-Radiological Features and Outcome of Skull Base versus Non-Skull Base Meningiomas Treated in Kuala Lumpur General Hospital: A Five-Year Experience
Chan, Chee Kong; Kandasamy, Regunath; Haspani, Saffari; Idris, Zamzuri & Abdullah, Jafri Malin
Abstract
Background: Meningiomas are the most common intracranial tumours; they account
for 13%–26% of all the primary intracranial tumours. Skull base meningiomas make up 25% of all
meningiomas and are one of the most difficult intracranial tumours to be managed surgically. This
is due to the fact that it is difficult to approach the lesions which are also close to vital structures
such as cranial nerves and major blood vessels. Despite the abundance of these cases in Malaysia,
local data on meningiomas is scarce.
Methods: This is a retrospective study consisting of 199 patients with meningiomas
who have been operated at the Kuala Lumpur General Hospital from January 2010–December
2014. They were categorised into skull base and non-skull base groups. Demography, tumour
characteristics, and patient outcomes were analysed. Kaplan-Meier survival curves as well as
Cox hazard univariable and multivariable regressions for the possible predictors of survival were
analysed.
Results: 97.5% of the patients (n = 194) had WHO grade I meningioma and only five
patients had WHO grade II meningioma. There was a female predominance (n = 134; 67.3%), with
a male-to-female ratio of 1:2. Some 27.1 % patients had skull base meningiomas. Patients with skull
base meningiomas had poorer outcomes and discharge conditions (n = 23; 42.6% P < 0.01), in
addition to higher risk of incomplete resections (n = 34; 63% P < 0.01). Multivariate cox hazard
regressions showed that the skull base meningioma group had four times the risk of death of the
non-skull base group.
Conclusions: Symptomatic meningiomas can be curative if the tumour is completely
removed. Our study has revealed that skull base meningiomas which were operated locally
had higher rates of incomplete resection and poorer surgical outcomes as compared to the nonskull
base group. Patients with skull base meningiomas had four times the risk of death vis-à-vis
non-skull base ones. More local studies are needed to look into skull base meningiomas for the
improvement of its surgical outcomes.
Keywords
meningioma; skull base; outcome
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© Copyright 2018 - Penerbit Universiti Sains Malaysia Alternative site location: http://www.medic.usm.my/publication/mjms/
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