Incidence, risk factors, and prognosis of meningiomas with distant metastases at presentation.

backgroundDistant metastases (DM) at presentation in meningiomas is a very rare event, and the incidence and factors predicting this are uncertain. This population-based study also aimed to investigate the prognostic implication of DM at presentation and clinical parameters to prognosticate the overall survival (OS) of meningiomas presenting with DM (M1).

methodsWe accessed the Surveillance, Epidemiology, and End Results program to search for patients who were diagnosed with meningioma between 2004 and 2016. The log-rank test was used to compare Kaplan-Meier survival curves and multivariate Cox regression model was utilized to evaluate the prognostic parameters of meningiomas with DM at presentation.

resultsThe incidence of DM at presentation among all meningiomas was 0.18%. Clinical variables associated with this event were male gender, large tumor size, and WHO grade III. The presence of DM at diagnosis conferred a shorter survival in comparison to those without DM (HR = 2.015; 95% CI = 1.600-2.536). Older patient age, male gender, malignant histology, and the lesser extent of resection were independent prognostic factors that could negatively impact OS of M1 meningiomas. Radiotherapy and chemotherapy were not associated with an improved outcome for these patients.

conclusionOur study highlighted the clinical and prognostic factors of M1 meningiomas. These data suggest that a greater extent of resection is associated with increased OS across a nationwide analysis and emphasize the need to establish the standards of care in these patients.