Purpose

Extraneural meningioma metastasis is a rare occurrence and may pose a clinical challenge due to its unclear prognosis. In this systematic review, we analyze patient demographics, clinical characteristics, management strategies, and outcomes.

Methods

PubMed, EMBASE, Scopus, Cochrane, and Web of Science databases were searched from inception to February 23, 2024 for cases of metastatic meningioma according to PRISMA guidelines. Descriptive statistics, Mann–Whitney U test, Fisher's exact tests, Kaplan–Meier curves, and log-rank tests were used for selected analyses.

Results

A total of 288 patients (52% male) were included with an average age of 49 years at meningioma diagnosis. Tumors were distributed across WHO grade 1 (38%), 2 (36%), and 3 (26%). Most patients experienced intracranial recurrence (79%) and mean time to first metastasis was approximately 8 years. No change in WHO grade between primary and metastasis was observed for most cases (65%). Treatment of the initial metastasis was most often with surgery (43%), chemotherapy (20%), or no treatment (14%). Half of the patients were alive (50%) with an average follow-up of 3 years following metastasis. Overall median survival was 36 months for the entire cohort. This differed significantly between WHO grade 1 versus 2/3 meningioma primaries (168 vs. 15 months, p < 0.005).

Conclusion

Metastatic meningioma appears to be associated with more positive prognosis than other brain tumor types with extra-neural metastasis or metastasis in general. This is particularly true for cases arising from a WHO grade 1 meningioma.

中文翻译：

---

神经外脑膜瘤转移的系统评价：时间、演变和前景

目的

神经外脑膜瘤转移很少见，由于其预后不明确，可能给临床带来挑战。在这篇系统综述中，我们分析了患者人口统计、临床特征、管理策略和结果。

方法

根据 PRISMA 指南，对 PubMed、EMBASE、Scopus、Cochrane 和 Web of Science 数据库从建库到 2024 年 2 月 23 日期间的转移性脑膜瘤病例进行了检索。描述性统计、Mann–Whitney U 检验、Fisher 精确检验、Kaplan–Meier 曲线和对数秩检验用于选定的分析。

结果

共有 288 名患者（52% 为男性）被纳入，脑膜瘤诊断时的平均年龄为 49 岁。肿瘤分布在 WHO 1 级（38%）、2 级（36%）和 3 级（26%）。大多数患者出现颅内复发（79%），首次转移的平均时间约为 8 年。对于大多数病例（65%），未观察到原发灶和转移灶之间的 WHO 分级变化。初次转移的治疗最常见的是手术（43%）、化疗（20%）或不治疗（14%）。转移后平均随访 3 年，一半患者存活（50%）。整个队列的总体中位生存期为 36 个月。 WHO 1 级脑膜瘤与 2/3 级脑膜瘤原发之间存在显着差异（168 个月与 15 个月，p < 0.005）。

结论

一般来说，与其他具有神经外转移或一般转移的脑肿瘤类型相比，转移性脑膜瘤似乎与更积极的预后相关。对于世界卫生组织 1 级脑膜瘤引起的病例尤其如此。