Microsurgical resection and Gamma Knife radiosurgery for olfactory groove meningiomas: A retrospective cohort study

IF 5.2 3区医学 Q1 SURGERY

Asian Journal of Surgery Pub Date : 2026-08-01 Epub Date: 2026-01-02 DOI:10.1016/j.asjsur.2025.12.132

Datong Zheng, Wenbo He, Yucheng Chen, Yu Hu, Ruilian Chen, Zhouhaoran Chen, Jingxuan Hou, Zhiyong Liu, Jianguo Xu

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引用次数: 0

Abstract

Background

Olfactory groove meningiomas (OGMs) are common anterior skull base tumors. While microsurgery is standard, it risks complications like olfactory impairment. Upfront Gamma Knife radiosurgery (GKRS) is an alternative, but comparative studies against surgery as an initial treatment are scarce.

Methods

This retrospective study (2009–2023) compared 59 patients undergoing initial microsurgery with 54 receiving upfront GKRS for OGMs at West China Hospital. Tumor control rates, Karnofsky Performance Status (KPS), and neurological function outcomes were analyzed to evaluate the appropriate treatment strategy for OGMs.

Results

Long-term tumor control was similar between initial microsurgery and upfront GKRS (Ten-year tumor control rates: 91.9% vs. 84.2%, P = 0.99). Upfront GKRS was associated with better patient quality of life (Mean KPS scores 93.1 vs. 87.0, P < 0.001), predicted by treatment modality (P = 0.027) and baseline KPS (P < 0.001). Olfactory preservation was superior after GKRS (98.0% vs. 86.4%, P = 0.048). Initial microsurgery (OR = 6.36, P = 0.032) and pre-treatment anosmia (OR = 91.05, P < 0.001) were independent predictors of post-treatment anosmia.

Conclusions

Both upfront GKRS and microsurgery offer excellent long-term OGM control. Treatment should be individualized. GKRS provides lower morbidity and superior olfactory preservation, making it preferable for smaller tumors without significant mass effect. Surgery remains necessary for larger or compressive lesions.

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显微外科切除和伽玛刀放射治疗嗅沟脑膜瘤：回顾性队列研究

背景dolfactory沟脑膜瘤（OGMs）是常见的前颅底肿瘤。虽然显微手术是标准的，但它有嗅觉损伤等并发症的风险。前期伽玛刀放射手术（GKRS）是一种替代方法，但对手术作为初始治疗的比较研究很少。方法回顾性研究（2009-2023）华西医院59例首次显微手术患者和54例术前行GKRS治疗的OGMs患者。分析肿瘤控制率、Karnofsky Performance Status （KPS）和神经功能结果，以评估OGMs的合适治疗策略。结果初始显微手术与术前GKRS的长期肿瘤控制率相似（10年肿瘤控制率：91.9% vs. 84.2%, P = 0.99）。通过治疗方式（P = 0.027）和基线KPS （P < 0.001）预测，前期GKRS与更好的患者生活质量相关（平均KPS评分93.1比87.0,P < 0.001）。GKRS后嗅觉保存效果较好（98.0%比86.4%,P = 0.048）。初始显微手术（OR = 6.36, P = 0.032）和治疗前嗅觉缺失（OR = 91.05, P < 0.001）是治疗后嗅觉缺失的独立预测因素。结论术前GKRS和显微手术均能较好地长期控制OGM。治疗应个体化。GKRS具有较低的发病率和良好的嗅觉保存，使其更适合较小的肿瘤，没有明显的肿块效应。对于较大或压缩性病变仍需手术治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Journal of Surgery 医学-外科

CiteScore

3.60

自引率

31.40%

发文量

1589

审稿时长

33 days

期刊介绍： Asian Journal of Surgery, launched in 1978, is the official peer-reviewed open access journal of the Asian Surgical Association, the Taiwan Robotic Surgery Association, and the Taiwan Society of Coloproctology. The Journal is published monthly by Elsevier and is indexed in SCIE, Medline, ScienceDirect, Scopus, Embase, Current Contents, PubMed, Current Abstracts, BioEngineering Abstracts, SIIC Data Bases, CAB Abstracts, and CAB Health. ASJSUR has a growing reputation as an important medium for the dissemination of cutting-edge developments in surgery and its related disciplines in the Asia-Pacific region and beyond. Studies on state-of-the-art surgical innovations across the entire spectrum of clinical and experimental surgery are particularly welcome. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance. The journal publishes original articles, review articles, and case reports that are of exceptional and unique importance.