Material and Method: The medical records of surgically treated intracranial meningioma patients with histological confirmation were reviewed. The diagnosis of recurrence was based on clinical condition and imaging study during follow-up. The recurrent rate, timing of recurrence, factors that influence the recurrence and clinical outcome were analyzed. Clinical outcome was measured by the Glasgow outcome scale.

Results: One hundred eighty one patients were recruited. Mean tumor diameter was 4.9 cm (1.2-9 cm). Mean follow-up was 32.3 months. Median recurrent time was 21.6 months and overall recurrent rate was 21.5% with 5-year recurrence-free survival rate of 65%. Factors associated with tumor recurrence were headache at presentation (p = 0.002), Simpson grade III (p = 0.012), Simpson grade IV (p<0.001), Simpson grade V (p = 0.004), WHO grade II (p = 0.004) and WHO grade III (p<0.001). Mortality rate in recurrent group was 12.8% compared with 3.5% in non-recurrent group (p = 0.039). The favorable outcome was higher in non-recurrent group 91.5% compared with 76.9% in recurrent group(p = 0.02483).

Conclusion: The risk factors of recurrence were headache at presentation, extent of resection, and histological grading. The extent of resection identified by Simpson grading effect the recurrent rate as stated previously in the literature. The higher histological grade was associated with higher recurrent rate. The wide range of timing of tumor recurrence needs both clinical evaluation and imaging study in short- and long-term follow-up especially in high-risk group. Recurrent meningioma increased rate of morbidity and mortality.

Keywords: Meningioma, Recurrence, Surgery