Medical student University of Medicine and Pharmacy at Ho Chi Minh city Ho Chi Minh, VN
Introduction: Chordoid meningiomas are rare, WHO grade II tumors, distinguished by their distinct histological features and a tendency to recur. The surgical treatment of these tumors presents significant challenges due to their intermediate grade and the complex anatomical locations in which they often occur. This systematic review and meta-analysis aim to critically evaluate and collect current evidence on the surgical management of chordoid meningiomas. The study evaluates outcomes such as the extent of tumor resection, recurrence rates, and mortality, with the goal of providing evidence-based recommendations for clinical practice.
Methods: A thorough literature search following PRISMA guidelines was conducted using PubMed, Scopus, and Web of Science, covering studies published up to July 2024. Studies included in the analysis involved patients diagnosed with chordoid meningiomas who underwent surgical treatment. Data extraction focused on patient demographics, surgical techniques and treatment outcomes. The meta-analysis utilized random-effects models, with heterogeneity assessed using I² statistics.
Results: After identification and screening of 689 articles, 18 studies reporting 407 patients were included for quantitative analysis. Gross total resection (GTR) was achieved in 86.45% of cases [95% CI: 80.60% to 92.30%] despite significant heterogeneity (I² = 69%). Recurrence occurred in 21.5% of patients [95% CI: 14.93% to 28.10%, I² = 60%]. Mortality was relatively low, with a pooled estimate of 4.85% [95% CI: 2.69% to 7.00%, I² = 0%]. Five-year progression-free survival (PFS) was 72% [95% CI: 63% to 81%].
Conclusion : Surgical resection remains the cornerstone of treatment for chordoid meningiomas, with GTR leading to favorable outcomes. However, recurrence remains a considerable concern, highlighting the need for adjuvant therapies and close follow-up. This study provides evidence-based insights to optimize the management of this rare tumor subtype.
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