国家神经系统疾病临床医学研究中心数据管理与共享系统

Intracranial LPRM is a rare subtype of meningioma with no gender difference and low recurrence. Long-term survival is expected, although tumors located in the skull base and bone destruction are independent risk factors of poor long-term outcomes. Microsurgical treatment of skull base LPRM remains a formidable challenge because of poorly defined borders and critical neurovascular structure encasement. Radical tumor resection, which induces severe neurologic deficits, is unnecessary.

LPRMs accounted for approximately 0.51% of intracranial meningiomas (56 of 10,908). Patients with LPRM had a mean age of 44.6 years and there was no significant gender preference (28 male and 28 female). Gross total resection was achieved in 45 cases, subtotal resection in 9 cases, and partial resection in 2 cases. At discharge, Karnofsky Performance Scale scores and neurologic function improved in 42 cases (75.0%) and worsened in 14 cases (25.0%). At the 41.5 months median follow-up (range, 5-97 months), 5 patients had tumor recurrence, and the 3-year and 5-year progression-free survival rates were 94.6% and 92.9%, respectively. One patient died of tumor recurrence. At the latest follow-up, Karnofsky Performance Scale scores improved in 48 cases (85.7%), worsened in 7 cases (12.5%), and 1 patient died (1.8%). Univariate analysis showed that the extent of tumor resection and tumors located in the skull base were significantly associated with short-term outcomes. Skull base location was significantly associated with increased risk of worse long-term outcomes. Tumor size ≥45 mm, poorly defined tumor border, and skull base location significantly limited the extent of tumor resection.