The Role of Surgery in Meningiomas

AbstractPurpose of reviewThis review presents the most recent evidences and recommendations in the pre-, intra-, and post-surgical management of patients harboring meningiomas. Due to the increasing relevance of multimodal approaches, in order to preserve patients ’ neurological function and quality of life (QoL), the role of observation and radiation treatments (as either primary or adjuvant therapy) has also been discussed.Recent findingsMultiple advances in neurosurgery, including the use of the microscope and endoscope, improved preoperative neuroimaging, intraoperative image-guided approaches, and intraoperative neurophysiological monitoring, have extended the neurosurgeon ’s ability to remove lesions that were previously considered only partially resectable or unresectable, while minimizing morbidity. On the other hand, the preservation of patients’ neurological integrity and QoL are increasingly important issues, more than complete tumor resection, for both pati ents and neurosurgeons. In this setting, stereotactic radiosurgery (SRS) and radiotherapy (RT) may be considered safe and effective alternatives for asymptomatic small- to moderate-sized tumors that demonstrate growth on serial imaging, or in combination with planned subtotal resection (STR) for tum ors in critical locations. Data supporting the use of pharmacotherapy in meningiomas are, to date, weak, but the strength of the evidence might improve in the next future with the identification of targetable ...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research