Evidence map›Paper›PMID 39912992›Full record

ArticleActa neurochirurgica2025

A retrospective comparison of active surveillance to stereotactic radiosurgery for the management of elderly patients with an incidental meningioma.

Hana Hallak, Georgios Mantziaris, Stylianos Pikis, Abdurrahman I Islim, Selcuk Peker, Yavuz Samanci, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Amr M N El-Shehaby and 14 more

Abstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Hana HallakDepartment of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Georgios MantziarisDepartment of Neurological Surgery, University of Virginia, P.O. Box 800212, Charlottesville, VA, USA.
Stylianos PikisDepartment of Neurological Surgery, University of Virginia, P.O. Box 800212, Charlottesville, VA, USA.
Abdurrahman I IslimTheWalton Centre NHS Foundation Trust, Liverpool, UK.
Selcuk PekerDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Yavuz SamanciDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Ahmed M NabeelGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
Wael A RedaGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
Sameh R TawadrosGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
Amr M N El-ShehabyGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
Khaled AbdelkarimGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
Reem M EmadGamma Knife Center Cairo-Nasser Institute, Benha University, Benha, Egypt.
David MathieuDivision of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, QC, Canada.
Cheng-Chia LeeDepartment of Neurosurgery, School of Medicine, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan.
Roman LiscakDepartment of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
Roberto Martinez AlvarezDepartment of Radiosurgery, Rúber International Hospital, Madrid, Spain.
Douglas KondziolkaDepartment of Neurosurgery, New York University, New York, NY, USA.
Manjul TripathiDepartment of Neurosurgery and Radiotherapy, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
Herwin SpeckterDepartment of Radiology, Dominican Gamma Knife Centerand, CEDIMAT, Santo Domingo, Pepillo Salcedo, Dominican Republic.
Greg N BowdenDepartment of Neurosurgery, University of Alberta, Edmonton, AB, Canada.
Ronald J BenvenisteDepartment of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Lawrence Dade LunsfordDepartment of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA.
Michael D JenkinsonTheWalton Centre NHS Foundation Trust, Liverpool, UK.
Jason SheehanDepartment of Neurological Surgery, University of Virginia, P.O. Box 800212, Charlottesville, VA, USA. jsheehan@virginia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionManagement for elderly patients (> 65yo) with incidental meningiomas remains unclear. This study aims to characterize the functional and tumor outcomes of expectant and stereotactic radiosurgery (SRS) management of asymptomatic meningioma elderly patients.

methodsUsing retrospectively collected data from 14 centers, SRS outcomes were compared to radiographic and clinical observation of asymptomatic meningiomas in elderly patients following propensity score matching.

resultsFollowing propensity score matching, 114 patients were in each cohort. Tumor control was achieved at 97.37% in the SRS cohort, and no meningioma growth was seen 71.93% of the observation cohorts (p < 0.01; OR 14.44 [95% CI 4.27-48.78]). New neurological deficits developed in 1.39% of the SRS cohort but in none of the patients managed conservatively. 3.5% of patients underwent resection in the active surveillance matched cohort compared to 0.9% of patients in the SRS cohort (p = 0.063; OR 0.135 [95% CI 0.163-1.117]). The all-cause mortality rate was almost half in the SRS group (9.65%) compared to the observation group (18.42%) (p = 0.06; OR 0.47 [95% CI .22-1.03]).

conclusionSRS achieves superior radiological tumor control compared to surveillance but with a slightly increased the risk of new SRS-related neurological deficits in elderly patients with asymptomatic meningiomas. Although SRS reduces meningioma progression, the need for of an open neurosurgical procedure and mortality were not significantly reduced. Furthermore, mortality in the observation group was not directly related to the meningioma in any of the patients.

Indexed as

Meningeal NeoplasmsMeningiomaRadiosurgeryWatchful WaitingAgedAged, 80 and overFemaleHumansIncidental FindingsMalePropensity ScoreRetrospective StudiesTreatment OutcomeElderlyMeningiomaStereotactic radiosurgerySurveillance

Identifiers

PMID39912992
PMCPMC11802698

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.