Discrepancies in the Natural History of Intracranial Meningioma between Men and Women

Objective: Meningiomas constitute 34% of all intracranial tumors and can induce a range of symptoms from mild to severe, potentially leading to fatal outcomes. Given their prevalence, being two to three times more common in women than in men, there has been comparatively less research on meningiomas in men. This study aims to examine the distinctive aspects of the natural history of meningiomas in both men and women concerning risk factors, tumor location, and prognosis.

Methods: All adults with a new diagnosis of intracranial meningioma in our institution between 2003 and 2021 were included. Patients’ variables collected included risk factors, symptoms, size and location of the tumor, follow-up time and treatments. Comparative analysis was conducted with the use of Student’s t-test and chi-square for means and proportions respectively. Kaplan–Meier method was used for survival analysis.

Results: A total of 1,861 patients (468 men, 1,393 women) were included. Men exhibited a higher mean BMI compared to women (28.7 vs. 27.6 kg/m², p = 0.026). Meningiomas were significantly closer to the midline in men (37 vs. 27%, p < 0.001). Men had more falcine (17 vs. 10%, p < 0.001) and parafalcine (9 vs. 6%, p = 0.025) meningiomas, whereas women had more cerebellopontine angle (8 vs. 4%, p = 0.004) and posterior fossa (5 vs. 1.5%, p = 0.001) meningiomas (Fig. 1).

Fig. 1 Precise location of meningiomas between men and women.

Men had significantly larger mean tumor volumes (40 vs. 25.4 cc, p < 0.001) at diagnosis and a higher prevalence of WHO grade 2 meningioma (22 vs. 9%, p < 0.001). Overall survival was significantly shorter in men than in women (142 vs. 173 months, p < 0.001; [Fig. 2]).

Fig. 2 Overall survival between men and women.

Progression-free survival after any treatment was also shorter in men than in women (121 vs. 151 months, p < 0.001; [Fig. 3]).

Fig. 3: Progression-free survival between men and women after their treatment.

Conclusion: We observed a more aggressive behavior of meningiomas in men, impacting their prognosis negatively. These findings suggest a need for closer monitoring of meningiomas in men, emphasizing the importance of gender-specific considerations in the management and treatment of these tumors.

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Artikel online veröffentlicht:
07. Februar 2025