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We read the study ‘Preoperative tumor embolization prolongs time to recurrence of meningiomas: a retrospective propensity-matched analysis’ by Akimoto et al1 with great interest. In this study, the authors study propensity-matched retrospective cohorts of 42 patients each to determine the impact of preoperative embolization on outcomes after resection of WHO grade 1 meningioma. All patients underwent preoperative catheter-based angiography. The authors found that embolization reduced blood loss and operative time, but did not improve gross total resection (GTR) rates. Recurrence-free survival (RFS) is 49 months for the embolized group and 24 months for the non-embolized group, a statistically significant finding, though the overall incidence of recurrence at follow-up is non-significant.
We believe this study’s generalizability is limited by the outcomes presented and statistical methods used in this study. Additionally, we share reservations about such high utilization of preoperative embolization.
The 5-year recurrence rate within the 84-patient cohort is 17%, stratified to approximately 10% after GTR (including Simpson grade 1–3 resection) and 50% after subtotal resection (STR). In recent studies of WHO grade 1 meningiomas, the 5-year …
Contributors SG and OA both contributed to analysis of the initial study as well as drafting and critically editing the commentary.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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