Spinal ventricular meningioma is a common intramedullary tumor in adults. Although the prognosis of ventricular meningioma is better compared to other intramedullary gliomas, the factors associated with its prognosis are still not well understood. There is a large body of literature supporting that complete tumor resection (GTR) improves overall survival (OS) and progression-free survival (PFS) in patients with spinal ventricular meningioma; however, not all ventricular meningiomas can be completely resected due to tumor infiltration of the surrounding spinal cord tissue and nerve roots. The need for postoperative adjuvant radiotherapy (RT) in patients with partial tumor resection (STR) remains controversial. Michael C, MD, PhD, of the Department of Neurosurgery at the University of California, reviewed the literature on the surgical treatment and radiotherapy of ventricular meningiomas between 1965 and 2011 and examined the relationship between different treatment modalities, GTR, STR, and STR+RT, and patient PFS and OS. The study was published in the February 2013 issue of Neuro-Oncology. A total of 68 publications were included in the study, including 348 patients with WHO grade II to WHO grade III intramedullary ventricular meningioma who underwent tumor resection, excluding cases who underwent biopsy only and those who received chemotherapy, with a median follow-up period of 48 months. The mean age of the patients was 41 years (18-73 years), with more men (57.6%) than women (42.4%). 268 patients (77.0%) underwent GTR and 80 patients underwent STR, with higher-grade tumors (83.0% total resection rate) being more likely to achieve total resection than lower-grade tumors (67.2% total resection rate) (P<0.001). Of all STR patients, 47 (58.8%) received adjuvant radiotherapy. The authors analyzed the impact of treatment measures on patient prognosis using both Kaplan-Meier survival curves and a multifactorial COX proportional risk model. The results showed that patients with completely resected ventricular meningiomas achieved the best PFS and OS, with five-year PFS and OS rates of 97.9% and 98.8%, respectively (HR=0.06; 95% CI=0.02-0.23; P<0.001). Among patients with STR, the median survival time (50% PFS) of patients who did not receive adjuvant radiotherapy was only 1/2 that of patients who received adjuvant radiotherapy postoperatively. had no effect (HR=1.01, P=0.99, Figure 2). In addition, the authors found that radiation dose (<50Gy vs. ≥50Gy) did not affect PFS (P=0.559) and OS (P=0.51, Figure 3) in patients with STR. In conclusion, the authors noted that although adjuvant radiotherapy did not improve the overall survival of patients with spinal ventricular meningioma, it did reduce tumor progression and thus prevent patients from undergoing multiple surgeries and improve their quality of life. Therefore, in spinal ventricular meningioma, total resection remains the primary treatment, and when total resection is not possible, adjuvant radiotherapy with close long-term follow-up is necessary. Figure 1: Progression-free survival (PFS) of patients with different treatment measures. Using the Kaplan-Meier curve, where patients with complete resection (GTR) had the best progression-free survival compared to those with partial resection (log rank, P<0.001), the group with partial tumor resection followed by radiotherapy (STR+RT group, 48 months) had twice the median survival time (50% PFS) compared to those with partial tumor resection alone (STR, 96 months). The median survival time (50% PFS) was twice as long for patients in the partial tumor resection group (STR, 96 months). Figure 2: Overall survival (OS) of patients with different treatment measures. Patients with total tumor resection had the best overall survival time. In patients with partially resected tumors, there was no significant difference in overall survival time with or without adjuvant chemotherapy. Figure 3: Kaplan-Meier analysis of the effect of different radiation doses on PFS and OS. pFS (A; P=0.559), OS (B; P=0.510) were not affected by radiation dose (<50Gy vs. ≥50Gy).