Postoperative peritumoral edema is correlated with the prognosis in intracranial meningioma with preoperative peritumoral edema

Preoperative peritumoral edema (PTE) in intracranial meningiomas is known to be a risk factor for postoperative recurrence. However, there are two groups: those in which preoperative PTE remains and those in which preoperative PTE receded after tumor removal. We aimed to investigate whether postoperative PTE could improve the prediction of prognosis of meningioma with preoperative PTE. 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 receded within 3 months after operation. Clinical manifestations, histopathology characteristics, radiology data and follow-up outcomes were noted. student's t-test and chi-square test for independence were used to compare clinical characteristics. Univariate and multivariate Cox analysis and Kaplan‒Meier methods were utilized to determine the independent effect of postoperative PTE on postoperative recurrence. Multivariate Cox analyses showed that the risk factors of meningioma recurrence: 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 STR (HR = 3.940, P = 0.003). Kaplan-Meier model showed that the progression-free survival of patients with postoperative PTE are shorter than who with postoperative PTE receded in 3 months after operation (HR = 3.30, P = 0.006). According to our research, we found that postoperative PTE in 3 months after operation is related to the outcomes of meningioma with preoperative PTE. Besides, we demonstrated that there were also some factors for recurrence: male, high WHO grades, superior sagittal sinus invasion and STR. These findings highlight the need for prospective study.