% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Qasem:299550,
      author       = {L.-E. Qasem and A. Al-Hilou and J. Oros and K. Weber$^*$
                      and F. Keil and D. Jussen and V. Prinz and V. Seifert and P.
                      Baumgarten and G. Marquardt and M. Czabanka},
      title        = {{S}ingle-stage versus two-stage resection for large
                      anterior midline skull base meningiomas with bihemispheric
                      peritumoral edema.},
      journal      = {Scientific reports},
      volume       = {15},
      number       = {1},
      issn         = {2045-2322},
      address      = {[London]},
      publisher    = {Springer Nature},
      reportid     = {DKFZ-2025-00494},
      pages        = {7926},
      year         = {2025},
      abstract     = {Resection of large anterior midline skull base meningiomas
                      with extensive peritumoral edema poses high risks due to
                      postoperative edema decompensation leading to increased
                      intracranial pressure. Initial craniectomy prevents
                      intracranial pressure decompensation but requires secondary
                      cranioplasty. This study compares single-stage osteoplastic
                      craniotomy with tumor resection to a two-stage approach
                      using bifrontal craniectomy, tumor resection and subsequent
                      cranioplasty after edema recovery in a second surgical step.
                      Patients with large anterior midline skull base meningiomas
                      (> 50 mm) and extensive peritumoral edema were included.
                      Group 1 underwent single-stage resection (2002-2016), while
                      Group 2 had a two-stage approach (2012-2022). The primary
                      outcome was the Karnofsky Performance Scale (KPS) at three
                      months post-surgery. Secondary outcomes included
                      preoperative KPS, KPS at discharge and last follow-up, ICU
                      stay, hospital stay length and complication rates. A total
                      of 25 patients were analyzed (Group 1: n = 9; Group 2: n =
                      16). Group 2 demonstrated significantly improved KPS at
                      three months postoperatively (median KPS $70\%$ vs. $50\%;$
                      p = 0.0204) with a non-significant reduction in ICU stay (10
                      vs. 6.5 days; p = 0.3284). Although no significant
                      differences were observed in KPS at discharge (Group 1: KPS
                      $30\%$ vs. Group 2: KPS $50\%;$ p = 0.1829) or last
                      follow-up (Group 1: KPS $60\%$ vs. Group 2: KPS $80\%;$ p =
                      0.1630), Group 2 patients required fewer postoperative
                      interventions for complications unrelated to cranioplasty.
                      Overall complication rates were comparable in both groups
                      (Group 1: $67\%$ vs. Group 2: $56\%;$ p = 0.6274). Two-stage
                      resection of large anterior midline skull base meningiomas
                      with extensive edema provides superior clinical outcomes at
                      three months postoperatively without increasing overall
                      complication rates. These findings support the use of a
                      two-stage surgical strategy for highly selected patients.
                      However, further multicenter studies are warranted to
                      validate these results in larger cohorts.},
      keywords     = {Humans / Male / Female / Meningioma: surgery / Meningioma:
                      pathology / Meningioma: complications / Middle Aged / Skull
                      Base Neoplasms: surgery / Skull Base Neoplasms: pathology /
                      Adult / Aged / Brain Edema: surgery / Brain Edema: etiology
                      / Meningeal Neoplasms: surgery / Meningeal Neoplasms:
                      pathology / Craniotomy: methods / Craniotomy: adverse
                      effects / Postoperative Complications: etiology / Treatment
                      Outcome / Retrospective Studies / Anterior skull base
                      meningiomas (Other) / Complications (Other) / Meningioma
                      (Other) / Olfactory groove meningiomas (Other) / Peritumoral
                      edema (Other) / Skull base surgery (Other)},
      cin          = {FM01},
      ddc          = {600},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40050641},
      doi          = {10.1038/s41598-025-92516-5},
      url          = {https://inrepo02.dkfz.de/record/299550},
}