Simpson describes the grading system of Sir Hugh Cairns et al for the extent of resection for a meningioma.
Extent of Resection
Other Factors
Grade
macroscopically complete of all tumor
(wide) resection of all visible dural attachments and extradural extension, include resection of an involved sinus
I
macroscopically complete of all tumor
resection of all visible dural attachments with cautery
II
macroscopically complete of intradural component
no resection and no cautery of dural attachments or extradural extension
III
partial removal
tumor left in situ
IV
none or simple biopsy
decompression; tumor left in situ
V
where:
• Extradural extension may involve invasion of a sinus or adjacent hyperostotic bone.
• I am not sure if Grade II involves resection of the extradural extension into bone.
The outcome depends on how fast the tumor recurs and where it is located. Good survivals are seen with Grade I and II resections. Even Grade V resections can have a prolonged outcome.
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