{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:09:44Z","timestamp":1767182984869,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Parasellar meningiomas, which may invade the cavernous sinus, pose a significant challenge to neurosurgeons due to the high risk of postoperative neurological deficits associated with aggressive resection of the intracavernous part of the tumour. Therefore, subtotal tumour removal followed by observation or radiotherapy for the residual meningioma in the cavernous sinus is recommended. This retrospective study aimed to identify prognostic factors influencing recurrence and progression-free survival (PFS) in parasellar meningiomas invading the cavernous sinus after incomplete surgical treatment. Methods: This study included adult patients diagnosed with benign parasellar meningioma (WHO Grade I) invading the cavernous sinus, treated at our institution between 2006 and 2020, and with a postsurgical follow-up of at least 3 years. Surgical treatment involved near-total resection (NTR) with an intracavernous residual tumour or subtotal resection (STR) with additional extracavernous tumour left in place. Kaplan\u2013Meier analysis estimated PFS rates, and Cox regression tested survival time differences between groups. Results: Among the 32 patients, the estimated median PFS was 11 years. Radiotherapy improved 5-year PFS only in patients with STR (p = 0.003). The univariate analysis identified preoperative tumour size, low preoperative Karnofsky Performance Score (KPS), and marked brain oedema as significant factors affecting meningioma progression after surgery. The multivariate analysis confirmed tumour size as an independent factor for progression (p = 0.012). Conclusions: For patients with parasellar meningioma invading the cavernous sinus, extracavernous tumour removal followed by close radiological surveillance of the residual intracavernous meningioma is a safe and appropriate strategy. When an extracavernous tumour component is left, adjuvant stereotactic radiotherapy or radiosurgery is recommended to control tumour growth.<\/jats:p>","DOI":"10.3390\/cancers16122217","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T08:02:26Z","timestamp":1718352146000},"page":"2217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of Tumor Progression after Microsurgery for Parasellar Meningioma Invading the Cavernous Sinus"],"prefix":"10.3390","volume":"16","author":[{"given":"Arkadiusz","family":"Nowak","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"Maj","sequence":"additional","affiliation":[{"name":"2nd Department of Clinical Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Marchel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Przemys\u0142aw","family":"Kunert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s11060-010-0386-3","article-title":"Epidemiology and etiology of meningioma","volume":"99","author":"Wiemels","year":"2010","journal-title":"J. Neurooncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1227\/01.NEU.0000125542.00834.6D","article-title":"Large sphenoid wing meningiomas involving the cavernous sinus: Conservative surgical strategies for better functional outcomes","volume":"54","author":"Froelich","year":"2004","journal-title":"Neurosurgery"},{"key":"ref_3","unstructured":"(2024, February 09). The Jamovi Project. Jamovi (Version 2.3) Computer Software. Available online: https:\/\/www.jamovi.org."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"491","DOI":"10.3171\/jns.2005.103.3.0491","article-title":"Sphenoorbital meningiomas: Surgical limitations and lessons learned in their long-term management","volume":"103","author":"Shrivastava","year":"2005","journal-title":"J. Neurosurg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1227\/01.NEU.0000140839.47922.5A","article-title":"Proposed treatment strategy for cavernous sinus meningiomas: A prospective study","volume":"55","author":"Maruyama","year":"2004","journal-title":"Neurosurgery"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"957","DOI":"10.3171\/2009.8.JNS09695","article-title":"Long-term control of petroclival meningiomas through radiosurgery","volume":"112","author":"Flannery","year":"2010","journal-title":"J. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.3171\/2019.2.JNS182604","article-title":"Petroclival meningiomas: Longterm outcomes of multimodal treatments and management strategies based on 30 years of experience at a single institution","volume":"132","author":"Kim","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_8","first-page":"1","article-title":"Risk of internal carotid artery stenosis or occlusion after single fraction radiosurgery for benign parasellar tumours","volume":"25","author":"Graffeo","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100864","DOI":"10.1016\/j.bas.2022.100864","article-title":"Management of cavernous sinus meningiomas: Consensus statement on behalf of the EANS skull base section","volume":"2","author":"Corniola","year":"2022","journal-title":"Brain Spine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"824","DOI":"10.3171\/jns.1983.58.6.0824","article-title":"Direct microsurgical repair of intracavernous vascular lesions","volume":"58","author":"Dolenc","year":"1983","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"937","DOI":"10.3171\/JNS-07\/11\/0937","article-title":"Long-term follow-up of meningiomas of the cavernous sinus after surgical treatment alone","volume":"107","author":"Sindou","year":"2007","journal-title":"J. Neurosurg."},{"key":"ref_12","first-page":"1","article-title":"Natural history of cavernous sinus meningiomas","volume":"1","author":"Amelot","year":"2018","journal-title":"J Neurosurg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1007\/s00701-018-3571-3","article-title":"Volumetric tumour growth rates of meningiomas involving the intracranial venous sinuses","volume":"160","author":"Ehresman","year":"2018","journal-title":"Acta Neurochir."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Masalha, W., Heiland, D.H., Steiert, C., Kr\u00fcger, M.T., Schnell, D., Heiland, P., Bissolo, M., Grosu, A.L., Schnell, O., and Beck, J. (2022). Management of Medial Sphenoid Wing Meningioma Involving the Cavernous Sinus: A Single-Center Series of 105 Cases. Cancers, 14.","DOI":"10.3390\/cancers14092201"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3171\/2018.10.JNS181480","article-title":"Outcomes of decompressive surgery for cavernous sinus meningiomas: Long-term follow-up in 50 patients","volume":"132","author":"Gozal","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/00006123-199607000-00002","article-title":"Recurrence of cranial base meningiomas","volume":"39","author":"Mathiesen","year":"1996","journal-title":"Neurosurgery"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3171\/2015.3.JNS142494","article-title":"Microsurgical resectability, outcomes, and tumour control in meningiomas occupying the cavernous sinus","volume":"125","author":"Nanda","year":"2016","journal-title":"J. Neurosurg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.3171\/2010.3.JNS091807","article-title":"Factors affecting outcome following treatment of patients with cavernous sinus meningiomas","volume":"113","author":"Sughrue","year":"2010","journal-title":"J. Neurosurg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1212\/01.WNL.0000138569.45818.50","article-title":"Natural history of conservatively treated meningiomas","volume":"63","author":"Herscovici","year":"2004","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1227\/NEU.0b013e31826adf65","article-title":"Meningiomas in pregnancy: A clinicopathologic study of 17 cases","volume":"71","author":"Lusis","year":"2012","journal-title":"Neurosurgery"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1227\/01.NEU.0000068730.76856.58","article-title":"The natural history of incidental meningiomas","volume":"53","author":"Nakamura","year":"2003","journal-title":"Neurosurgery"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.3171\/2010.12.JNS101623","article-title":"The natural history of intracranial meningiomas","volume":"114","author":"Oya","year":"2011","journal-title":"J. Neurosurg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"373","DOI":"10.3171\/2014.8.JNS132406","article-title":"Petroclival meningiomas resected via a combined transpetrosal approach: Surgical outcomes in 60 cases and a new scoring system for clinical evaluation","volume":"122","author":"Morisako","year":"2015","journal-title":"J. Neurosurg."},{"key":"ref_24","first-page":"615","article-title":"Impact of the Extent of Microsurgical Resection in Sphenopetro-clival Meningiomas Trough a Multistaged Approach: A Volumetric Analysis","volume":"82","author":"Tsimpas","year":"2020","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3171\/jns.1996.84.1.0020","article-title":"Petroclival meningiomas: Surgical experience in 109 cases","volume":"84","author":"Couldwell","year":"1996","journal-title":"J. Neurosurg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"860","DOI":"10.3171\/jns.1994.81.6.0860","article-title":"Surgical excision of meningiomas involving the clivus: Preoperative and intraoperative features as predictors of postoperative functional deterioration","volume":"81","author":"Sekhar","year":"1994","journal-title":"J. Neurosurg."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2217\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:58:30Z","timestamp":1760108310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,14]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["cancers16122217"],"URL":"https:\/\/doi.org\/10.3390\/cancers16122217","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2024,6,14]]}}}