Patient-evaluated outcome after surgery for basal meningiomas.

Abstract

To study the outcomes of patients with basal meningiomas treated by one primary surgeon with a philosophy of aggressive surgical management to establish an index of satisfaction and patient-evaluated outcome. We collected prospective data for patients with basal meningiomas who were operated on by one primary surgeon (LNS) during a 7-year period from 1993 to 2000. The outcomes in 269 patients were ascertained through follow-up visits, mailed follow-up questionnaires, and telephone interviews by two other surgeons (RA and MN). The mean patient age was 50 +/- 13.6 years. The mean estimated tumor diameter was 3.07 +/- 1.24 cm. There were 62 males and 207 females. Mean follow-up was 49 +/- 26 months. Twenty-seven percent of patients were Levine-Sekhar (LS) Grade 0, 43% were LS Grade I, 24% were LS Grade II, and 6% were LS Grade III. Gross total resection was achieved in 66% of patients. Extent of resection correlated (P < 0.05) with LS grade. Thirty-seven patients received adjuvant treatments, and six patients required reoperations. Perioperative mortality was 1.1%. Eighty percent of patients were discharged home, 17% were discharged to rehabilitation facilities, and 1.5% were discharged to nursing homes. Postoperative complications were observed in 30% of patients. During the follow-up study, of a total of 269 patients, 30 patients could not be contacted, and 11 patients had died of unrelated causes. The mean follow-up Karnofsky Performance Scale score of the patients was 83 +/- 10. Ninety-seven percent of patients were very satisfied/satisfied with their treatments (P < 0.001). Forty-three percent of patients were employed, and 83% of patients were employable. Their expectations of treatment were met in 90% of patients (P < 0.001), 95% thought surgery had been a good treatment choice (P < 0.001), and 95% would recommend the same treatment for a family member (P < 0.001). These results demonstrate that patient satisfaction can remain high and satisfactory outcome can be achieved with surgical management in patients with these complex lesions.