Edema peritumoral em meningiomas benignos: correlação com fatores clínicos, radiológicos, cirúrgicos e com recorrência tumoral / Peritumoral brain edema in benign meningiomas: Correlation with clinical, radiological and surgical factors and role on recurrence

AUTOR(ES)

André Simis

DATA DE PUBLICAÇÃO

2007

RESUMO

INTRODUCTION: Approximately 60% of meningiomas are associated with peritumoral edema.Various causative factors have been discussed in the literature. PURPOSES: Investigate the correlation of peritumoral edema with clinical, radiological and surgical aspects, and recurrence rate of meningiomas. METHODS: Sixty one benign meningiomas submitted to surgical treatment by the Group of Brain Tumors and Metastasis of the Division of Neurosurgery of the Hospital das Clínicas of São Paulo Medical School of São Paulo University. All patients underwent complete surgical ressection (Simpson 1 and 2) and were excluded the atypical and malignant hystopathological grades. The tumors located in the cavernous sinus, tuberculum sellae region, foramen magnum region, ventricular space and petroclival region were excluded. RESULTS: Edema extention had a positive correlation with the higher recurrence rates (p = 0,042) and with the presence of irregular margins (p <0,011) on bivariate analysis. Meningiomas with greater edema sizes also showed correlation with large meningiomas (p = 0,035) and the ones with smaller edema sizes correlated with the tentorial location (p=0,032). Multivariate analysis showed an association between peritumoral brain edema and the presence of seizures (Odds ratio=3,469), large meningiomas (Odds ratio=15,977), and for each cubic centimeter added to its size, the risk of edema increased 1,082 times (Odds ratio). CONCLUSION: Peritumoral brain edema correlated with recurrence, irregular margins, seizures and larger tumors. The tentorial location demonstrated smaller edema sizes. Peritumoral brain edema may be related to meningiomas invading potentiality and may play a role in the recurrence pontential of the tumor. As a consequence, its reasonable to consider edemas presence as an additional factor to be taken into account when arranging layout of strategies for meningiomas treatment.

ASSUNTO(S)

neurocirurgia meningioma/cirurgia brain edema/etiology meningioma/surgery recurrence neurosurgery edema encefálico/etiologia recidiva

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