NCOG-06. Multimodal management of meningioma: Experience from a low-middle-income country

Abstract BACKGROUND AND OBJECTIVE There are many studies in existing scientific literature documenting the outcomes of excision of meningioma, but none of them combine clinical aspects with radiology and histopathology with adjuvant options. We aimed to evaluate the effects of multimodal management (MMM) for supratentorial meningioma (STM) in terms of their surgical outcome and functional status of patients. Methodology This retrospective, observational study analyzed consecutive cases of surgically excised cases of STM at the Department of Neurosurgery, Punjab Institute of Neurosciences from January 2022 to August 2024. Data was collected from patients’ records and pictures archiving and communication system (PACS), including clinical presentation, radiological reports, operative findings, postoperative stay, regimen of adjuvant therapy and functional status using Google Forms. RESULTS There were 60 patients with a mean age of 45.90±13.05 years, the majority being males (65%, 39). Gross total resection was achieved in 48.3% (29) of cases. Post-operative GCS scores were 13-15 in 95% (57) of patients, and 60% (36) experienced no complications. Histopathology showed 85% (51) of meningiomas were WHO grade I, with 70% (42) meningothelial and 10% (6) fibrous. Most (90%, 54) of them did not require adjuvant therapy, with average pre-treatment and post-treatment KPS of 77.17 ± 21.64 and 83.00 ± 28.95, respectively. WHO grade II tumors (10%, 6), including atypical and clear-cell types, were treated with adjuvant therapy in 5% (3) of all cases, with KPS scores of 76.32 ± 19.54 and 82.13 ± 26.35. WHO grade III tumors were found in 5% (3) of cases and were all treated with adjuvant therapy, with KPS scores of 75.13 ± 19.34and 80.21 ± 26.72. CONCLUSION MMM of STM based on comprehensive clinical assessment, timely neuroimaging work up, surgery and appropriate referrals for adjuvant therapy based on WHO tumor grades reduces the risk of postoperative complications and improves the functional status of patients overall.