Walsh & Hoyt: Adjuvant Therapy

Recurrence (or progressive growth of remaining tumor) is a problematic feature of meningiomas. The key to preventing recurrence of intracranial meningiomas is complete surgical excision. However, independent risk factors include radiation-induced tumors (especially if the radiation was delivered during childhood) and chromosomal alteration. Jaaskelainen evaluated the rate of late recurrence and factors predicting recurrence in 657 patients and found a recurrence rate at 20 years of 19% using life-table analysis. In an attempt to decrease recurrence rates when complete excision is difficult (e.g., medial sphenoid wing, cavernous sinus, and olfactory groove meningiomas), adjuvant therapy can be used. A wide variety of markers have been reported to help predict which meningiomas will recur, but at this time none are used clinically in most patients with meningiomas.