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This study aimed to estimate the prognostic factors, long-term outcomes, and surgical strategies for parasagittal meningioma (PSM) and provide a better understanding of surgical experience. Patients ( n  = 1438) who underwent surgery for meningioma between January 2012 and January 2013 were enrolled in a database. We then identified 165 patients with PSM based on this database. Of the 165 patients with identified PSMs, 103 were female and 62 were male, with a mean age of 49 years. Univariate analysis revealed that male sex ( p  = .002), non-World Health Organization (WHO) grade I meningioma ( p  &lt; .001), treatment history ( p  = .006), surgical time more than 232 minutes ( p  = .006), and intraoperative bleeding &gt; 300mL 3  ( p  = .019) were associated with decreased progression-free survival (PFS). Multivariate analysis revealed that sex (hazards ratio [HR] = 3.836, 95% confidence interval [CI] = 1.364–10.794;  p  = .011], tumour grade (HR = 8.479, 95% CI = 3.234–22.230;  p  &lt; .001), and surgical time (HR = 3.710, 95% CI = 1.057–13.023;  p  = .041) were independent factors for PFS. Patients with Simpson grade I-II ( p  = .015), no-treatment history ( p  = .006), tumour size &lt; 3cm ( p  = .005), surgical time &lt; 232 minutes ( p  = .019), intraoperative bleeding &lt; 300mL 3  ( p  &lt; .001), or WHO grade I meningioma ( p  = .002) had better follow-up conditions. Surgery was an effective treatment for PSM, and at the time of final follow-up, patients who received aggressive resection had a substantially higher Karnofsky performance scale score.

Surgical outcomes and prognostic factors of parasagittal meningioma: a single-center experience 165 consecutive cases