{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:22:19Z","timestamp":1792092139318,"version":"4.4.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Definitive data allowing clinicians to predict which meningioma patients will fail to respond to conservative management are lacking. To address this need, the authors systematically reviewed the published literature regarding the natural history of small, untreated meningiomas.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors performed a systematic review of the existing literature on untreated meningiomas that were followed with serial MR imaging. They summarize the published linear rates of tumor growth, and the risk factors for development of new or worsened symptoms during follow-up by using a stratified chi-square test.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The search methods identified 22 published studies reporting on 675 patients with untreated meningiomas followed by serial MR imaging. Linear growth rates varied significantly: no growth was the most common rate, although reports of more aggressive tumors noted growth rates of up to a 93% linear increase in size per year. The authors found that few patients with initial tumor diameters &lt; 2 cm went on to develop new or worsened symptoms over a median follow-up period of 4.6 years. Patients with initial tumor diameters of 2\u20132.5 cm demonstrated a marked difference in the rate of symptom progression if their tumors grew &gt; 10% per year, compared with those tumors growing \u2264 10% per year (42% vs 0%; p &lt; 0.001, chi-square test). Patients with tumors between &gt; 2.5 and 3 cm in initial size went on to develop new or worsened symptoms 17% of the time.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This systematic review of the literature regarding the clinical behavior of untreated meningiomas suggests that most meningiomas \u2264 2.5 cm in diameter do not proceed to cause symptoms in the approximately 5-year period following their discovery. Those that do cause symptoms can usually be predicted with close radiographic follow-up. Based on these findings, the authors suggest the importance of observation in the early course of treatment for small asymptomatic meningiomas, especially those with an initial diameter &lt; 2 cm.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.3.jns091966","type":"journal-article","created":{"date-parts":[[2010,4,30]],"date-time":"2010-04-30T14:15:20Z","timestamp":1272636920000},"page":"1036-1042","source":"Crossref","is-referenced-by-count":126,"title":["Treatment decision making based on the published natural history and growth rate of small meningiomas"],"prefix":"10.3171","volume":"113","author":[{"given":"Michael E.","family":"Sughrue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J.","family":"Rutkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derick","family":"Aranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor J.","family":"Barani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Parsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns091966","series-title":"Surg Neurol","first-page":"87","article-title":"The natural history of untreated skull base meningiomas","volume":"59","author":"Bindal","year":"2003"},{"key":"b2-jns091966","series-title":"Neurology","first-page":"1459","article-title":"Meningiomas: the decision not to operate","volume":"48","author":"Braunstein","year":"1997"},{"key":"b3-jns091966","series-title":"J Neurosurg","first-page":"545","article-title":"Growth rate of incidental meningiomas","volume":"73","author":"Firsching","year":"1990"},{"key":"b4-jns091966","series-title":"Int J Radiat Oncol Biol Phys","first-page":"801","article-title":"Gamma knife radiosurgery of imaging-diagnosed intracranial meningioma","volume":"56","author":"Flickinger","year":"2003"},{"key":"b5-jns091966","series-title":"Neurology","first-page":"1718","article-title":"The natural history of asymptomatic meningiomas in Olmsted County, Minnesota","volume":"51","author":"Go","year":"1998"},{"key":"b6-jns091966","series-title":"Int J Radiat Oncol Biol Phys","first-page":"1324","article-title":"Gamma knife radiosurgery for skull base meningiomas: long-term radiologic and clinical outcome","volume":"72","author":"Han","year":"2008"},{"key":"b7-jns091966","series-title":"J Neurosurg","first-page":"675","article-title":"Serial volumetric assessment of the natural history and growth pattern of incidentally discovered meningiomas. Clinical article","volume":"110","author":"Hashiba","year":"2009"},{"key":"b8-jns091966","series-title":"Neurology","first-page":"1133","article-title":"Natural history of conservatively treated meningiomas","volume":"63","author":"Herscovici","year":"2004"},{"key":"b9-jns091966","series-title":"Neurol Med Chir (Tokyo)","first-page":"592","article-title":"Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors\u2014 their natural history and surgical indications","volume":"39","author":"Igarashi","year":"1999"},{"key":"b10-jns091966","series-title":"J Neurosurg","first-page":"804","article-title":"Gamma Knife radiosurgery for skull base meningioma: long-term results of low-dose treatment. Clinical article","volume":"109","author":"Iwai","year":"2008"},{"key":"b11-jns091966","series-title":"No Shinkei Geka","first-page":"891","article-title":"[The treatment for asymptomatic meningiomas in the era of radiosurgery.]","volume":"31","author":"Iwai","year":"2003"},{"key":"b12-jns091966","series-title":"J Neurosurg","first-page":"44","article-title":"Long-term outcomes after meningioma radiosurgery: physician and patient perspectives","volume":"91","author":"Kondziolka","year":"1999"},{"key":"b13-jns091966","series-title":"Neurosurgery","first-page":"53","article-title":"Radiosurgery as definitive management of intracranial meningiomas","volume":"62","author":"Kondziolka","year":"2008"},{"key":"b14-jns091966","series-title":"J Neurosurg","first-page":"766","article-title":"Incidence and clinical features of asymptomatic meningiomas","volume":"92","author":"Kuratsu","year":"2000"},{"key":"b15-jns091966","series-title":"Minim Invasive Neurosurg","first-page":"44","article-title":"Meningioma followed up for radiological findings before and after radiosurgery: case report","volume":"42","author":"Kuroiwa","year":"1999"},{"key":"b16-jns091966","series-title":"Int Ophthalmol","first-page":"207","article-title":"Intraocular meningothelial meningiomas","volume":"12","author":"Mani","year":"1988"},{"key":"b17-jns091966","series-title":"J Neurosurg","article-title":"A comparison of World Health Organization tumor grades at recurrence in patients with non-skull base and skull base meningiomas","author":"McGovern"},{"key":"b18-jns091966","series-title":"No Shinkei Geka","first-page":"27","article-title":"[Strategy for the treatment of incidental meningiomas.]","volume":"35","author":"Nabika","year":"2007"},{"key":"b19-jns091966","series-title":"Neurosurgery","first-page":"62","article-title":"The natural history of incidental meningiomas","volume":"53","author":"Nakamura","year":"2003"},{"key":"b20-jns091966","series-title":"Neurosurgery","first-page":"946","article-title":"Growth pattern changes of meningiomas: longterm analysis","volume":"56","author":"Nakasu","year":"2005"},{"key":"b21-jns091966","series-title":"J Neurol Neurosurg Psychiatry","first-page":"25","article-title":"Natural history of elderly patients with asymptomatic meningiomas","volume":"68","author":"Niiro","year":"2000"},{"key":"b22-jns091966","series-title":"J Neurosurg","first-page":"222","article-title":"The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients","volume":"83","author":"Olivero","year":"1995"},{"key":"b23-jns091966","series-title":"Surg Neurol","first-page":"160","article-title":"The selection of the optimal therapeutic strategy for petroclival meningiomas","volume":"66","author":"Park","year":"2006"},{"key":"b24-jns091966","series-title":"Br J Ophthalmol","first-page":"1265","article-title":"Stereotactic fractionated irradiation of optic nerve sheath meningioma: a new treatment alternative","volume":"86","author":"Pitz","year":"2002"},{"key":"b25-jns091966","series-title":"Arch Ophthalmol","first-page":"704","article-title":"Spontaneous visual improvement in orbital apex tumors","volume":"114","author":"Pless","year":"1996"},{"key":"b26-jns091966","series-title":"J Neurooncol","first-page":"337","article-title":"Stereotactic radiosurgery of benign intracranial tumors","volume":"92","author":"Pollock","year":"2009"},{"key":"b27-jns091966","series-title":"Neurosurgery","first-page":"55","article-title":"Natural history of petroclival meningiomas","volume":"52","author":"Van Havenbergh","year":"2003"},{"key":"b28-jns091966","series-title":"N Engl J Med","first-page":"1821","article-title":"Incidental findings on brain MRI in the general population","volume":"357","author":"Vernooij","year":"2007"},{"key":"b29-jns091966","series-title":"J Neurosurg","first-page":"538","article-title":"Indications for surgery in patients with asymptomatic meningiomas based on an extensive experience","volume":"105","author":"Yano","year":"2006"},{"key":"b30-jns091966","series-title":"Acta Neurochir (Wien)","first-page":"507","article-title":"Growth of incidental meningiomas","volume":"142","author":"Yoneoka","year":"2000"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/5\/article-p1036.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/5\/article-p1036.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/5\/article-p1036.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T04:45:20Z","timestamp":1679892320000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/5\/article-p1036.xml"}},"subtitle":["A review and meta-analysis"],"short-title":[],"issued":{"date-parts":[[2010,11]]},"references-count":30,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2010.3.jns091966","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11]]}}}