title: Sphenoid wing meningiomas: Surgical strategies and evaluation of prognostic factors influencing clinical outcomes.
abstract: OBJECTIVE
  To study microsurgical technique and prognostic factors influencing clinical outcomes in a series of 53 patients with sphenoid wing meningiomas (SWMs).
  
  
  METHODS
  The clinical materials of 53 patients with sphenoid wing meningiomas treated microsurgically between January 2008 and January 2012 were analyzed retrospectively. Follow-up period ranged from 6 to 62 months (median, 34 months). Clinical outcomes including postoperative quality of life and recurrence rate were evaluated. Univariate and multivariate statistical analysis were performed among factors that might influence postoperative quality of life.
  
  
  RESULTS
  In our group, the mean age of patients was 49 years. Mean tumor size was 3.9cm. Total tumor resection was achieved in 38 cases (71.7%), subtotal in 10 cases (18.9%) and partial resection in 5 cases (9.4%). Within the follow-up period, ten patients (18.9%) had recurrence and three patients (5.7%) died. In univariate analysis, we found the postoperative Karnofshky Performance Score (KPS) improvement was determined by various factors, including extent of tumor resection, peritumoral edema, tumor blood supply, size, adhesion, encasement and preoperative KPS. However, multivariate analysis showed that complete resection, rich blood supply, adhesion to adjacent structure, encasement of neurovascular were independent predictive factors for worse postoperative KPS.
  
  
  CONCLUSIONS
  With the improved requirement of postoperative quality of life in patients, intentional incomplete resection should be considered as an acceptable treatment option. Multivariate analysis confirmed that incomplete resection, poor blood supply, lack of adhesion or encasement of adjacent structure were independent predictive factors for favorable postoperative quality of life. An individual treatment strategy could help improved quality of life.
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Taohui
authors.initials: T
authors.lastname: Ouyang
authors.affiliation: Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Long
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China. Electronic address: husttjchen110@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000469:parasitology / Q000601:surgery*; D008579:Meningioma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D013100:Sphenoid Bone; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Meningioma; Microsurgery; Multivariate analysis; Quality of life; Sphenoid wing