====== University Hospital Bonn ======

Klinik und Poliklinik für Neurochirurgie
Rheinische Friedrich-Wilhelms-Universität
Sigmund-Freud-Straße 25
53127 Bonn [[Germany]]

https://www.neurochirurgie-bonn.de/

Prof. Dr. med. Dr. med. habil. 
Hartmut VATTER
Direktor
Tel.: 0228/28716501
Fax: 0228/28716573
hartmut.vatter@ukb.uni-bonn.de

Mohammed Banat

Valeri Borger 
----

Gousias et al., [[review]]ed their institutional experience with a policy based on [[maximal safe resection]]s for [[meningioma]]s, and they analyzed the impact of the degree of [[resection]] on [[functional outcome]] and [[progression free survival]] (PFS).

They retrospectively analyzed 901 consecutive patients with primary meningiomas (716 WHO Grade I, 174 Grade II, and 11 Grade III) who underwent resections at the University Hospital of [[Bonn]] between 1996 and 2008. Clinical and treatment parameters as well as tumor characteristics were analyzed using standard statistical methods. 

The median follow-up was 62 months. PFS rates at 5 and 10 years were 92.6% and 86.0%, respectively. Younger age, higher preoperative Karnofsky Performance Scale (KPS) score, and convexity tumor location, but not the degree of resection, were identified as independent predictors of a good functional outcome (defined as KPS Score 90-100). Independent predictors of PFS were degree of resection (Simpson Grade I vs II vs III vs IV), MIB-1 index (< 5% vs 5%-10% vs >10%), histological grade (WHO I vs II vs III), tumor size (≤ 6 vs > 6 cm), tumor multiplicity, and location. A Simpson Grade II rather than Grade I resection more than doubled the risk of recurrence at 10 years in the overall series (18.8% vs 8.5%). The impact of aggressive resections was much stronger in higher grade meningiomas. 

A policy of maximal safe resections for meningiomas prolongs PFS and is not associated with increased morbidity
((Gousias K, Schramm J, Simon M. The Simpson grading revisited: aggressive
surgery and its place in modern meningioma management. J Neurosurg. 2016
Sep;125(3):551-60. doi: 10.3171/2015.9.JNS15754. Epub 2016 Jan 29. PubMed PMID:
26824369.
)).

===== Publications =====

see [[Bonn publications]].