Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study

Stylianos Pikis; Georgios Mantziaris; Abdurrahman I Islim; Selcuk Peker; Yavuz Samanci; Ahmed M Nabeel; Wael A Reda; Khaled Abdelkarim; Amr M N El-Shehaby; Sameh R Tawadros; Reem M Emad; Violaine Delabar; David Mathieu; Cheng-Chia Lee; Huai-Che Yang; Roman Licsak; Jaromir Hanuska; Roberto Martinez Alvarez; Dev N Patel; Douglas Kondziolka; Kenneth Bernstein; Nuria Martinez Moreno; Manjul Tripathi; Herwin Speckter; Camilo Albert; Greg N Bowden; Ronald J Benveniste; Dade L Lunsford; Michael D Jenkinson; Jason Sheehan

doi:10.1007/s11060-022-03953-5

Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study

Stylianos Pikis, Georgios Mantziaris, Abdurrahman I Islim, Selcuk Peker, Yavuz Samanci, Ahmed M Nabeel, Wael A Reda, Khaled Abdelkarim, Amr M N El-Shehaby, Sameh R Tawadros, Reem M Emad, Violaine Delabar, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, Roman Licsak, Jaromir Hanuska, Roberto Martinez Alvarez, Dev N Patel, Douglas KondziolkaKenneth Bernstein, Nuria Martinez Moreno, Manjul Tripathi, Herwin Speckter, Camilo Albert, Greg N Bowden, Ronald J Benveniste, Dade L Lunsford, Michael D Jenkinson, Jason Sheehan

Division of Neuroscience

University of Virginia

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: The optimal treatment strategy of asymptomatic, convexity meningiomas, remains unclear.

OBJECTIVE: The purpose of this study was to define the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with asymptomatic convexity meningiomas.

METHODS: Data of SRS-treated patients from 14 participating centers and patients managed conservatively for an asymptomatic, convexity-located meningioma were compared. Local tumor control rate and development of new neurologic deficits were evaluated in the active surveillance and in the SRS-treated cohorts.

RESULTS: In the unmatched cohorts, there were 99 SRS-treated patients and 140 patients managed conservatively for an asymptomatic, convexity meningioma. Following propensity score matching for age, there were 98 patients in each cohort. In the matched cohorts, tumor control was achieved in 99% of SRS-treated, and in 69.4% of conservatively managed patients (p < 0.001). New neurological deficits occurred in 2.0% of patients in each of the matched cohorts (p = 1.00). Increasing age was predictive of tumor growth [(OR 1.1; 95% CI (1.04 - 1.2), (p < 0.001)].

CONCLUSION: This is one of the first reports to suggest that SRS is a low risk and effective treatment strategy for asymptomatic incidentally discovered convexity meningiomas. In this study, tumor control was achieved in significantly more patients after radiosurgery compared to those managed with active surveillance. SRS may be offered at diagnosis of an asymptomatic convexity meningioma and should be recommended when meningioma growth is noted on follow-up.

Original language	English
Pages (from-to)	121-128
Number of pages	8
Journal	Journal of Neuro-Oncology
Volume	157
Issue number	1
DOIs	https://doi.org/10.1007/s11060-022-03953-5
Publication status	Published - Mar 2022

Keywords

Cohort Studies
Follow-Up Studies
Humans
Meningeal Neoplasms/epidemiology
Meningioma/pathology
Radiosurgery/adverse effects
Retrospective Studies
Treatment Outcome
Watchful Waiting

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Pikis, S., Mantziaris, G., Islim, A. I., Peker, S., Samanci, Y., Nabeel, A. M., Reda, W. A., Abdelkarim, K., El-Shehaby, A. M. N., Tawadros, S. R., Emad, R. M., Delabar, V., Mathieu, D., Lee, C.-C., Yang, H.-C., Licsak, R., Hanuska, J., Alvarez, R. M., Patel, D. N., ... Sheehan, J. (2022). Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study. Journal of Neuro-Oncology, 157(1), 121-128. https://doi.org/10.1007/s11060-022-03953-5

@article{ef81be4a5f66414b85c13d724a9220e7,

title = "Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study",

abstract = "BACKGROUND: The optimal treatment strategy of asymptomatic, convexity meningiomas, remains unclear.OBJECTIVE: The purpose of this study was to define the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with asymptomatic convexity meningiomas.METHODS: Data of SRS-treated patients from 14 participating centers and patients managed conservatively for an asymptomatic, convexity-located meningioma were compared. Local tumor control rate and development of new neurologic deficits were evaluated in the active surveillance and in the SRS-treated cohorts.RESULTS: In the unmatched cohorts, there were 99 SRS-treated patients and 140 patients managed conservatively for an asymptomatic, convexity meningioma. Following propensity score matching for age, there were 98 patients in each cohort. In the matched cohorts, tumor control was achieved in 99% of SRS-treated, and in 69.4% of conservatively managed patients (p < 0.001). New neurological deficits occurred in 2.0% of patients in each of the matched cohorts (p = 1.00). Increasing age was predictive of tumor growth [(OR 1.1; 95% CI (1.04 - 1.2), (p < 0.001)].CONCLUSION: This is one of the first reports to suggest that SRS is a low risk and effective treatment strategy for asymptomatic incidentally discovered convexity meningiomas. In this study, tumor control was achieved in significantly more patients after radiosurgery compared to those managed with active surveillance. SRS may be offered at diagnosis of an asymptomatic convexity meningioma and should be recommended when meningioma growth is noted on follow-up.",

keywords = "Cohort Studies, Follow-Up Studies, Humans, Meningeal Neoplasms/epidemiology, Meningioma/pathology, Radiosurgery/adverse effects, Retrospective Studies, Treatment Outcome, Watchful Waiting",

author = "Stylianos Pikis and Georgios Mantziaris and Islim, {Abdurrahman I} and Selcuk Peker and Yavuz Samanci and Nabeel, {Ahmed M} and Reda, {Wael A} and Khaled Abdelkarim and El-Shehaby, {Amr M N} and Tawadros, {Sameh R} and Emad, {Reem M} and Violaine Delabar and David Mathieu and Cheng-Chia Lee and Huai-Che Yang and Roman Licsak and Jaromir Hanuska and Alvarez, {Roberto Martinez} and Patel, {Dev N} and Douglas Kondziolka and Kenneth Bernstein and Moreno, {Nuria Martinez} and Manjul Tripathi and Herwin Speckter and Camilo Albert and Bowden, {Greg N} and Benveniste, {Ronald J} and Lunsford, {Dade L} and Jenkinson, {Michael D} and Jason Sheehan",

note = "{\textcopyright} 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = mar,

doi = "10.1007/s11060-022-03953-5",

language = "English",

volume = "157",

pages = "121--128",

journal = "Journal of Neuro-Oncology",

issn = "1573-7373",

publisher = "Kluwer Academic Publishers",

number = "1",

}

Pikis, S, Mantziaris, G, Islim, AI, Peker, S, Samanci, Y, Nabeel, AM, Reda, WA, Abdelkarim, K, El-Shehaby, AMN, Tawadros, SR, Emad, RM, Delabar, V, Mathieu, D, Lee, C-C, Yang, H-C, Licsak, R, Hanuska, J, Alvarez, RM, Patel, DN, Kondziolka, D, Bernstein, K, Moreno, NM, Tripathi, M, Speckter, H, Albert, C, Bowden, GN, Benveniste, RJ, Lunsford, DL, Jenkinson, MD & Sheehan, J 2022, 'Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study', Journal of Neuro-Oncology, vol. 157, no. 1, pp. 121-128. https://doi.org/10.1007/s11060-022-03953-5

TY - JOUR

T1 - Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas

T2 - a matched cohort analysis from the IMPASSE study

AU - Pikis, Stylianos

AU - Mantziaris, Georgios

AU - Islim, Abdurrahman I

AU - Peker, Selcuk

AU - Samanci, Yavuz

AU - Nabeel, Ahmed M

AU - Reda, Wael A

AU - Abdelkarim, Khaled

AU - El-Shehaby, Amr M N

AU - Tawadros, Sameh R

AU - Emad, Reem M

AU - Delabar, Violaine

AU - Mathieu, David

AU - Lee, Cheng-Chia

AU - Yang, Huai-Che

AU - Licsak, Roman

AU - Hanuska, Jaromir

AU - Alvarez, Roberto Martinez

AU - Patel, Dev N

AU - Kondziolka, Douglas

AU - Bernstein, Kenneth

AU - Moreno, Nuria Martinez

AU - Tripathi, Manjul

AU - Speckter, Herwin

AU - Albert, Camilo

AU - Bowden, Greg N

AU - Benveniste, Ronald J

AU - Lunsford, Dade L

AU - Jenkinson, Michael D

AU - Sheehan, Jason

PY - 2022/3

Y1 - 2022/3

N2 - BACKGROUND: The optimal treatment strategy of asymptomatic, convexity meningiomas, remains unclear.OBJECTIVE: The purpose of this study was to define the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with asymptomatic convexity meningiomas.METHODS: Data of SRS-treated patients from 14 participating centers and patients managed conservatively for an asymptomatic, convexity-located meningioma were compared. Local tumor control rate and development of new neurologic deficits were evaluated in the active surveillance and in the SRS-treated cohorts.RESULTS: In the unmatched cohorts, there were 99 SRS-treated patients and 140 patients managed conservatively for an asymptomatic, convexity meningioma. Following propensity score matching for age, there were 98 patients in each cohort. In the matched cohorts, tumor control was achieved in 99% of SRS-treated, and in 69.4% of conservatively managed patients (p < 0.001). New neurological deficits occurred in 2.0% of patients in each of the matched cohorts (p = 1.00). Increasing age was predictive of tumor growth [(OR 1.1; 95% CI (1.04 - 1.2), (p < 0.001)].CONCLUSION: This is one of the first reports to suggest that SRS is a low risk and effective treatment strategy for asymptomatic incidentally discovered convexity meningiomas. In this study, tumor control was achieved in significantly more patients after radiosurgery compared to those managed with active surveillance. SRS may be offered at diagnosis of an asymptomatic convexity meningioma and should be recommended when meningioma growth is noted on follow-up.

AB - BACKGROUND: The optimal treatment strategy of asymptomatic, convexity meningiomas, remains unclear.OBJECTIVE: The purpose of this study was to define the safety and efficacy of stereotactic radiosurgery (SRS) in the management of patients with asymptomatic convexity meningiomas.METHODS: Data of SRS-treated patients from 14 participating centers and patients managed conservatively for an asymptomatic, convexity-located meningioma were compared. Local tumor control rate and development of new neurologic deficits were evaluated in the active surveillance and in the SRS-treated cohorts.RESULTS: In the unmatched cohorts, there were 99 SRS-treated patients and 140 patients managed conservatively for an asymptomatic, convexity meningioma. Following propensity score matching for age, there were 98 patients in each cohort. In the matched cohorts, tumor control was achieved in 99% of SRS-treated, and in 69.4% of conservatively managed patients (p < 0.001). New neurological deficits occurred in 2.0% of patients in each of the matched cohorts (p = 1.00). Increasing age was predictive of tumor growth [(OR 1.1; 95% CI (1.04 - 1.2), (p < 0.001)].CONCLUSION: This is one of the first reports to suggest that SRS is a low risk and effective treatment strategy for asymptomatic incidentally discovered convexity meningiomas. In this study, tumor control was achieved in significantly more patients after radiosurgery compared to those managed with active surveillance. SRS may be offered at diagnosis of an asymptomatic convexity meningioma and should be recommended when meningioma growth is noted on follow-up.

KW - Cohort Studies

KW - Follow-Up Studies

KW - Humans

KW - Meningeal Neoplasms/epidemiology

KW - Meningioma/pathology

KW - Radiosurgery/adverse effects

KW - Retrospective Studies

KW - Treatment Outcome

KW - Watchful Waiting

U2 - 10.1007/s11060-022-03953-5

DO - 10.1007/s11060-022-03953-5

M3 - Article

C2 - 35092547

SN - 1573-7373

VL - 157

SP - 121

EP - 128

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

IS - 1

ER -

Stereotactic radiosurgery versus active surveillance for incidental, convexity meningiomas: a matched cohort analysis from the IMPASSE study

Abstract

Keywords

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