Distinct clinical characteristics and prognostic factors of pediatric meningiomas in a 10-year cohort of 198 patients
摘要
Pediatric meningiomas are rare, with poorly characterized clinical profiles and prognostic factors. This study aimed to characterize their clinical features, outcomes, and predictors of tumor recurrence. A retrospective analysis of 198 pediatric (< 18 years old) meningioma patients (2014–2023) from Beijing Tiantan Hospital was performed. Clinical, radiological and pathological characteristics were collected and analyzed. Log-rank test and multivariate Cox proportional hazards regression analysis were used to identify independent prognostic factors for recurrence. Males comprised 52.02% of the total cohort. Preoperative imaging misdiagnosis was frequent, with 90 patients (45.45%) not diagnosed with meningioma. The skull base was the most common tumor site (70 cases, 35.35%), followed by intraventricular locations (31 cases, 15.66%). Notably, parenchymal meningiomas accounted for 9.60% of cases (19 cases). Focal neurological deficits were most common initial symptoms (75 cases, 37.88%), followed by intracranial hypertension (53 cases, 26.77%) and seizure-related symptoms (31 cases, 15.66%). Gross total resection was achieved in 75.76% patients. High-grade (WHO grade 2–3) tumors accounted for 43.43% but showed no significant association with recurrence (P = 0.688). The 5-year PFS rate was 83.26%, 10-year PFS rate was 73.38%; the 5-year OS rate was 96.91%, and 10-year OS rate was 89.06%. Multivariate Cox analysis identified age < 14 years (P = 0.024), partial resection (P = 0.026), and prior recurrence (P = 0.012) as independent factors for recurrence. Pediatric meningiomas display a distinct clinical profile characterized by frequent imaging misdiagnosis, high proportion of intraventricular/parenchymal location, and elevated high-grade pathology. Younger age (< 14 years), partial resection, and recurrence history are key independent prognostic factors for recurrence. Clinical trial number: not applicable.