Evaluation of Risk Factors for Recurrence of Laterosellar Meningiomas

Background : Evaluation of recurrence risk factors of meningiomas located in the laterosellar region is important to achieve and to adapt the therapeutic strategy. Therefore, we analyzed this risk of bone invasion or cavernous sinus involvement of these meningiomas. Methods : A retrospective study from 1991 to 2007 included patients who were operated for a meningioma of the laterosellar region. They were classified in three groups according to their topography: (group 1) anterior clinoid meningiomas; (group 2) “en plaque” sphenoorbital or (group 3)cavernous sinus meningiomas. Their extension into the cavernous sinus or of the bone of the base skull was analyzed on MRI and at surgery. Results : A total of 94 patients were operated; out of which 29 patients relapsed (2 in group 1, 15 in group 2, and 12 in group 3). Sphenoorbital “en plaque” meningiomas had a HR = 4.40 risk for recurrence when the cavernous sinus is involved ( p = 0.007) with a 95% CI (1.49-12.98). Cavernous sinus meningiomas have a HR = 4.06 risk for recurrence when bone is invaded ( p = 0.073) with 95% CI (0.87-18.84). Cavernous sinus meningiomas have a likelihood of recurrence of 83% if the bone is invaded ( p = 0.05). Conclusion : For meningiomas of the laterosellar region, the bone invasion and the cavernous sinus involvement are the major risk factors for recurrence. The cavernous sinus involvement without a bone invasion is not a risk factor. Thus, in case of bone and cavernous involvement a combination of surgery and radiation therapy should be proposed.