髄膜腫摘出術前塞栓術の腫瘍再発抑制効果

Preoperative Embolization Performed Before Meningioma Resection Might Inhibit Tumor Recurrence

Point

・髄膜腫に対する腫瘍塞栓術は主に術中出血量の低減目的で行われるが，長期的にみると再発を抑制する効果も有している可能性がある．

　Recent advances in endovascular treatment have improved the safety and efficacy of this procedure, and the number of cases in which preoperative embolization is performed is likely to increase. Preoperative tumor embolization is still a controversial treatment, and as long as it carries a risk of complications, its primary benefit of reducing blood loss during surgery may not be sufficient to justify treatment. We recently reported that preoperative embolization does not significantly increase complications, but may prolong recurrence-free survival. However, currently, tumor embolization is only a preoperative adjunctive therapy, and there is no evidence that it is a stand-alone option for meningioma treatment. Nevertheless, the possibility that tumor embolization alone can promote tumor shrinkage and reduce peripheral oedema has been reported, although the number of cases is small. Further research is needed, but in the future, tumor embolization may become an in-office treatment under certain conditions, such as in cases of poor general condition, multiple meningiomas, recurrent and refractory cases, difficult surgery and cases where re-irradiation is difficult after post-radiation therapy.