Recurrence of Anterior Skull Base Meningioma after Endoscopic Endonasal Resection. Retrospective Review of a Series of 28 Cases over Ten Years
Bibliographic record
Abstract
Introduction: While the advantages and complications of the expanded endoscopic endonasal (EEE) approach for the removal of olfactory groove (OGM) and tuberculum sellae & planum (TSM) are known, there is little data on the long term recurrence rates. Objectives: After a review of the previously published series, we report the recurrent cases in our series trying to identify predictors of recurrence. We report on and attempt to correlate pre- and postoperative imaging, operative technique (extent of resection) and pathology (tumor grade), which may be related to recurrence. Material and Methods: Twenty-eight cases, (6 OGM and 22 TSM), operated on between May 2006 and December 2015 were retrospectively reviewed with special emphasis of the recurrence. Results: In our series gross total resection (GTR) was achieved in 4/6 OGM (60%) and 15/22 (68%) TSM patients. The mean follow up was 29 months. Among these 28 patients, 4 (14.2%) presented with a recurrence; 2 cases (1 OGM, 1 TSM) of regrowing residual tumor and 2 (1 OGM, 1 TSM) cases of recurrence after total resection. All of them had WHO grade I lesions. One patient (OGM) had undergone a prior resection of an intracranial component by transcranial approach 8 years before. All of these 4 cases did not experience any postoperative complication and recurred respectively at 40, 29, 41, and 19 months following the EEE approach, with a mean time of 32 months. One patient underwent an open approach for the recurrence and a second patient is to undergo stereotactic radiation. Conclusion: The potential for recurrence of anterior skull base meningiomas operated upon with an endoscopic endonasal approach is yet not well known. This report has shown a 14% early recurrence after EEE. This will have to be compared with recurrence rates in transcranial approaches. However further studies with longer follow up of patients are needed to provide a more meaningful analysis. This data could allow refinement of the operative technique and better understanding of the limitations of the expanded EEE approach to anterior skull base meningiomas.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".