caa a22 4500 445329041 CHVBK 20180317142731.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s10143-011-0308-7 doi (NATIONALLICENCE)springer-10.1007/s10143-011-0308-7 Treatment policy for petroclival meningioma based on tumor size: aiming radical removal in small tumors for obtaining cure without morbidity [Elektronische Daten] [Iwao Yamakami, Yoshinori Higuchi, Kentaro Horiguchi, Naokatsu Saeki] Aggressive tumor removal is not always the best treatment for petroclival meningioma (PCM). However, radical removal actually provides the cure with minimal morbidity. We evaluated the relation of surgical results and tumor size in the PCM removal to clarify the treatment policy for PCM. This study comprised 32 consecutive patients with newly-diagnosed PCM who underwent tumor removal; tumor size was small (< 3cm) in 12 patients and large (≥3cm) in 20. Tumor removal was classified into radical (Simpson's grade I/II) and non-radical (Simpson's grade III/IV). Removal of small PCM was 11 radical and one non-radical; no surgical morbidity/mortality occurred and postoperative regular follow-up using magnetic resonance imaging showed no recurrence in the period of 66 ± 45months. Removal of large PCM was eight radical and 12 non-radical; despite no mortality, the incidence of permanent cranial nerve deficits and major neurological deficits newly developed postoperatively was 35% and 25%, respectively. Radical removal was significantly more frequent in small PCMs than in large PCMs. Permanent cranial nerve deficits newly developed postoperatively and poor outcome (Karnofsky score ≤80) were significantly more frequent in large PCMs than in small PCMs. Radical removal of small PCM is achieved with minimal morbidity and results in the cure. Notwithstanding high morbidity, aggressive removal of large PCM does not achieve a high rate of radical removal. To find and remove PCM radically while it is small is the only way to cure the disease with minimal morbidity. Springer-Verlag, 2011 Meningioma nationallicence Petroclival nationallicence Skull base nationallicence Tumor removal nationallicence Treatment nationallicence Yamakami Iwao Neurosurgery, Chiba Central Medical Center, 1835-1 Kasori-cho, Wakaba-ku, 264-0017, Chiba, Japan aut Higuchi Yoshinori Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut Horiguchi Kentaro Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut Saeki Naokatsu Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 327-335 0344-5607 34:3<327 2011 34 10143 https://doi.org/10.1007/s10143-011-0308-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-011-0308-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yamakami Iwao Neurosurgery, Chiba Central Medical Center, 1835-1 Kasori-cho, Wakaba-ku, 264-0017, Chiba, Japan aut NATIONALLICENCE 700 1- Higuchi Yoshinori Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut NATIONALLICENCE 700 1- Horiguchi Kentaro Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut NATIONALLICENCE 700 1- Saeki Naokatsu Neurosurgery, Chiba University Graduate School of Medicine, Chiba, Japan aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/3(2011-07-01), 327-335 0344-5607 34:3<327 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer