Postoperative peritumoral edema can predict the prognosis in intracranial meningioma with preoperative peritumoral edema

Abstract Purpose Peritumoral edema (PTE) in intracranial meningiomas correlates to surgical outcomes. But only depending on preoperative PTE in meningioma does not accurately predict the prognosis after resection. We aimed to investigate whether postoperative PTE could improve the prognosis prediction of meningioma patients with preoperative PTE. Methods We retrospectively reviewed postoperative MRI scans in 3 months after operation of 371 patients with preoperative PTE of meningioma that underwent surgery between 2015 and 2017. All the patients were classified into two different groups according to whether had postoperative PTE fadeaway within 3 months after operation. Clinical manifestations, histopathology characteristics, radiology data and follow-up outcomes were noted. T-tests and chi-square tests were used to compare clinical characteristics. Univariate and multivariate Cox analysis and Kaplan‒Meier method were utilized to screen for clinical prognostic factors. Result Kaplan-Meier model showed that the progression-free survival of patients with postoperative PTE are shorter than who with postoperative PTE fadeaway in 3 months after operation (HR = 3.30 ,P = 0.006). Multivariate Cox analyses showed that the predictors for recurrence of meningioma with preoperative: high WHO grades (HR = 4.989, P＜0.001), superior sagittal sinus invasion (HR = 2.290, P = 0.047), postoperative PTE in 3 months after operation (HR = 1.804, P = 0.044) and subtotal resection (HR = 3.940, P = 0.003). Conclusion According to our research, we found that postoperative PTE in 3 months after operation can predict the outcomes of patients of meningioma with preoperative PTE. Besides, we demonstrated that there were also some predictors for recurrence: male, high WHO grades, superior sagittal sinus invasion and subtotal resection.