The prognosis for patients with an intracranial meningioma is generally good.[59]Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957 Feb;20(1):22-39.
http://www.ncbi.nlm.nih.gov/pubmed/13406590?tool=bestpractice.com
[111]Jaaskelainen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol. 1986 Mar;25(3):233-42.
http://www.ncbi.nlm.nih.gov/pubmed/3945904?tool=bestpractice.com
[112]Mirimanoff RO, Dosoretz DE, Linggood RM, et al. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg. 1985 Jan;62(1):18-24.
http://www.ncbi.nlm.nih.gov/pubmed/3964853?tool=bestpractice.com
These are nonmalignant tumors in the vast majority of cases, and, if removed adequately (including dural attachment), have a good prognosis. If treated with radiosurgery or fractionated radiation therapy, the control rate exceeds 90% at 10 years.[83]Kondziolka D, Levy EI, Niranjan A, et al. Long-term outcomes after meningioma radiosurgery: physician and patient perspectives. J Neurosurg. 1999 Jul;91(1):44-50.
http://www.ncbi.nlm.nih.gov/pubmed/10389879?tool=bestpractice.com
[113]Milker-Zabel S, Zabel A, Schulz-Ertner D, et al. Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: long-term experience and prognostic factors. Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):809-16.
http://www.ncbi.nlm.nih.gov/pubmed/15708260?tool=bestpractice.com
Interestingly, there are few studies with long-term follow-up of meningioma patients, which is relevant to younger patients diagnosed with meningioma. One study of parasagittal meningiomas with a 25-year follow-up period found that, even for World Health Organization (WHO) grade 1 meningiomas that were completely resected, recurrence rates were as high as 38%. This suggests the need for ongoing follow-up and longitudinal studies to better characterize the long-term prognosis.[114]Pettersson-Segerlind J, Orrego A, Lönn S, et al. Long-term 25-year follow-up of surgically treated parasagittal meningiomas. World Neurosurg. 2011 Dec;76(6):564-71.
http://www.ncbi.nlm.nih.gov/pubmed/22251505?tool=bestpractice.com
Studies have investigated factors associated with quality of life and adjustment to brain tumor. Health-related quality of life typically improves after surgery, but declines in the long term.[50]Goldbrunner R, Stavrinou P, Jenkinson MD, et al. EANO guideline on the diagnosis and management of meningiomas. Neuro Oncol. 2021 Nov 2;23(11):1821-34.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563316
http://www.ncbi.nlm.nih.gov/pubmed/34181733?tool=bestpractice.com
[115]Wang JZ, Landry AP, Raleigh DR, et al. Meningioma: International Consortium on meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients. Neuro Oncol. 2024 Oct 3;26(10):1742-80.
https://academic.oup.com/neuro-oncology/article/26/10/1742/7663195
http://www.ncbi.nlm.nih.gov/pubmed/38695575?tool=bestpractice.com
Review of these studies has identified consistent associations between depression, performance status, fatigue, and quality of life.[116]Ownsworth T, Hawkes A, Steginga S, et al. A biopsychosocial perspective on adjustment and quality of life following brain tumor: a systematic evaluation of the literature. Disabil Rehabil. 2009;31(13):1038-55.
http://www.ncbi.nlm.nih.gov/pubmed/19116809?tool=bestpractice.com
Other factors associated with lower quality of life include larger tumor size, higher WHO grade, recurrence, shorter time since diagnosis, age ≥50 years, post-traumatic stress, personality changes, tumors located in the left hemisphere, headache, and seizures.[50]Goldbrunner R, Stavrinou P, Jenkinson MD, et al. EANO guideline on the diagnosis and management of meningiomas. Neuro Oncol. 2021 Nov 2;23(11):1821-34.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563316
http://www.ncbi.nlm.nih.gov/pubmed/34181733?tool=bestpractice.com