Pediatric meningiomas: a meta-analysis of clinical, pathological and prognostic data of 887 patients

Abstract Background Pediatric meningiomas differ from adult meningiomas in histology, location, and biological behavior. Available data are limited to single case reports and small case studies. Therefore, this meta-analysis aimed to re-evaluate clinicopathologic data of pediatric meningiomas and their correlation with treatment and patient outcomes. Methods A literature search was conducted using the terms “meningioma,” “children,” “childhood,” and “pediatric.” Articles published between 01/1989 and 03/2023 that focused on pediatric meningiomas and provided patient follow-up were included. Study heterogeneity was assessed using funnel and forest plots with both fixed- and random-effects models. Histologic and clinical characteristics were evaluated in relation to mortality and recurrence rates using meta-regression. Results For the meta-analysis, 45 studies with a total of 887 patients were included for further analysis and ­interpretation. Studies reporting falx (CI: 0.367 [0.144–0.59]; P = .001) and cerebellopontine angle (CPA) meningiomas (CI: 0.17 [0.035–0.305]; P = .014) showed increased mortality. Studies with falx localization (CI: 0.307 [0.015–0.6]; P = .04) and age over 10 years (CI: 0.751 [0.139–1.52]; P = .018) demonstrated increased recurrence rates. In regression analysis, falx and CPA localization was not associated with sex, resection status, radiotherapy, or WHO grade. Conclusion Tumor location—particularly in the falx and CPA regions—appears to have a significant impact on recurrence and mortality in pediatric patients. Surgery aiming for gross total resection remains the treatment of choice, while perioperative and long-term postoperative risks must be carefully weighed.