Intracranial Meningioma Surgery In The Elderly(Over 65 Years): Prognostic Factors And Outcome

OBJECTIVE This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection.METHODS From 2007 to 2013,86 patients (aged 65 or older) diagnosed with an intracranial meningioma were surgically treated within our neurosurgery department. The clinical and radiology data were reviewed, as well as the follow-up records. Univariate and multivariate logistic analyses were performed to identify the relationships between various factors (age, sex, neurological condition, concomitant disease, American Society of Anesthesiology (ASA) classification, preoperative Karnofsky Performance Scale (KPS) score, tumor location and size, peritumoral edema, and Simpson resection grade) and outcome.RESULTS One patient (1.2%) died within 30 days after surgery. The morbidity rates were 37.2%. Postoperative morbidities more frequently occurred in the patients with preoperative neurological deficits compared with the patients without neurological deficits (p=0.049). The univariate analysis identified significant relationships between a low KPS score (≤70) at discharge and preoperative neurological deficits, a low preoperative KPS score (≤70) and critical tumor location (p<0.001, p<0.001 and p=0.04, respectively). When the multivariate logistic analysis was performed, only the preoperative KPS score remained significant for the KPS score at discharge (p=0.005). There was no significant association between these factors and the most recent KPS score.CONCLUSION The outcome of intracranial meningioma resection in elderly individuals is favorable if the preoperative KPS score is >70 and no neurological deficits are present. Treatment decisions should be patient specific, and additional factors should be considered when operations are performed in patients with a low preoperative KPS score or neurological deficits.