BACKGROUND: Postoperative seizures after surgical resection of intracranial meningiomas will negatively affect the quality of life of patients. The aim of the present meta-analysis was to pool the current data and identify the independent predictors of postoperative seizures to better guide postoperative surveillance. METHODS: Searches of 4 electronic databases from inception to February 2019 were conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines. We identified 430 reports for screening. The hazard ratios (HRs) of the preoperative and postoperative parameters from ≥3 separate multivariate regression analyses were pooled using a meta-analysis of the proportions. RESULTS: Of the 430 reports, 12 satisfied the criteria for inclusion in the present study. The pooled population of 5681 patients with meningioma had a median age of 56 years (range, 50-61) and a median proportion of World Health Organization grade I of 91% (range, 66-100). From these data, 4 statistically significant, independent predictors of postoperative seizures were identified: 1) preoperative seizure history (HR, 3.53; P < 0.01), 2) non-skull base location (HR, 2.35; P < 0.01), 3) postoperative complications (HR, 3.95; P < 0.01), and 4) meningioma recurrence (HR, 3.69; P < 0.01). However, the certainty of these results ranged from low to moderate. CONCLUSIONS: We identified 4 significant independent predictors of postoperative seizures after meningioma resection. These parameters should be considered in the follow-up of these patients to ensure optimal seizure surveillance, although ultimate validation by prospective studies is still required.
BACKGROUND:Postoperative seizures after surgical resection of intracranial meningiomas will negatively affect the quality of life of patients. The aim of the present meta-analysis was to pool the current data and identify the independent predictors of postoperative seizures to better guide postoperative surveillance. METHODS: Searches of 4 electronic databases from inception to February 2019 were conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines. We identified 430 reports for screening. The hazard ratios (HRs) of the preoperative and postoperative parameters from ≥3 separate multivariate regression analyses were pooled using a meta-analysis of the proportions. RESULTS: Of the 430 reports, 12 satisfied the criteria for inclusion in the present study. The pooled population of 5681 patients with meningioma had a median age of 56 years (range, 50-61) and a median proportion of World Health Organization grade I of 91% (range, 66-100). From these data, 4 statistically significant, independent predictors of postoperative seizures were identified: 1) preoperative seizure history (HR, 3.53; P < 0.01), 2) non-skull base location (HR, 2.35; P < 0.01), 3) postoperative complications (HR, 3.95; P < 0.01), and 4) meningioma recurrence (HR, 3.69; P < 0.01). However, the certainty of these results ranged from low to moderate. CONCLUSIONS: We identified 4 significant independent predictors of postoperative seizures after meningioma resection. These parameters should be considered in the follow-up of these patients to ensure optimal seizure surveillance, although ultimate validation by prospective studies is still required.
Authors: Freya Sophie Jenkins; Flavio Vasella; Luis Padevit; Valentino Mutschler; Kevin Akeret; Julia Velz; Luca Regli; Johannes Sarnthein; Marian Christoph Neidert Journal: Acta Neurochir (Wien) Date: 2021-07-14 Impact factor: 2.216