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Long-term outcomes of pediatric meningioma surgery: single center experience with 23 patients.

AIM
Childhood meningiomas are rare group of tumors that differ from adult counterparts and there is paucity of literature regarding their long-term outcomes. In this study, our aim was to evaluate long-term outcomes and prognostic variables in a surgical cohort of pediatric meningiomas treated at a single institution.


MATERIAL AND METHODS
Medical records and follow-up notes of 23 pediatric patients (age 18 years) harboring 27 meningiomas operated between 1994 and 2019 at Hacettepe University Children's Hospital were evaluated.


RESULTS
There were 12 male and 11 female patients. Mean age at presentation was 13.1±4.4 years. There were one patient with NF1 and 5 patients with NF2. Most common location of tumor was convexity (n=6) and parasagittal/falcine (n=6). Gross total resection was performed in 70.4% of cases. WHO grade I tumors accounted for 56% of all cases, whereas high grade meningiomas were present in 44% (33% grade II, 11% grade III). Mean follow-up duration was 10.3±7.7 years. Three patients (13%) died during follow-up, and 76.2% of the patients had favorable outcome (GOS 3) at the time of last follow-up assessment. Relapses occurred in 10 patients (43.5%). In univariate analysis, low histologic grade (p=0.030) and gross total resection (p=0.024) were associated with favorable outcome. 10-year overall survival rate was 86%.


CONCLUSION
Meningiomas in the pediatric age group are surgically treatable tumors with fairly good outcomes. However relapses are not uncommon even for low grade tumors, therefore long-term surveillance and aggressive treatment is needed.