LONG-TERM FOLLOW-UP OF PATIENTS WITH MENINGIOMAS INVOLVING THE CAVERNOUS SINUS - RECURRENCE, PROGRESSION, AND QUALITY-OF-LIFE

OBJECTIVE: In this report, we evaluate the recurrence- and progression -free survival of patients with meningiomas involving the cavernous si nus. METHODS: The rates of tumor recurrence and progression in 119 pat ients with meningiomas involving the cavernous sinus treated between 1 983 and 1993 were analyzed. RESULTS: The mean follow-up period was 33. 8 months. There were seven recurrences of completely resected tumors ( 7 of 73, 10%) and seven progressions of incompletely resected tumors ( 7 of 46, 15%). Life table analysis of recurrence-and progression-free survival was performed. The recurrence-free survival rate was 94% at 3 years and 81% at 5 years. In contrast, the progression-free survival rate was 87% at 3 years and 62% at 5 years (P = 0.0456). There were tw o patterns of recurrence or progression. The first group of tumors had an aggressive biological behavior with growth at multiple areas of re section; the second group showed growth at or near the margins of rese ction. Functional status continued to improve slowly during the follow -up period; however, there was no statistically significant difference between the Karnofsky scores obtained 3 to 12 months postoperatively and the follow-up Karnofsky scores (obtained > 1 yr postoperatively). CONCLUSION: Surgery for meningiomas involving the cavernous sinus seem s to provide excellent tumor control. Our experience suggests that for the majority of these tumors, complete tumor resection can be perform ed with acceptable risks of morbidity and mortality and seems to incre ase the duration of recurrence-free survival. The long-term quality of life of surviving patients is satisfactory, with the great majority o f the patients being independent.