Prognostic implications of meningiomas in the elderly (over 70 years old) in the era of magnetic resonance imaging.

Abstract

During the 5 years from 1987 to 1991, 89 elderly patients, aged 70 years and over, were admitted to departments of neurosurgery in Yamaguchi prefecture with meningioma. The clinical features and prognostic implications of meningioma in the elderly were assessed retrospectively. Seventy-eight (88%) of the 89 patients underwent surgery, which was a higher rate than has been previously reported. The length of clinical history was also shorter than in previous studies, and was partly due to the recent introduction of magnetic resonance imaging (MRI). The incidence of poor prognosis (severe disability, vegetative or dead) in the elderly and a younger group aged less than 70 years was 13% and 7%, respectively, but the difference was not statistically significant. In the surgically treated elderly group, age did not influence the patient's outcome. The factors affecting the outcome were pre-operative neurological deficit (p < 0.05), histological malignancy (p < 0.05), and multiple operations (p < 0.05). Twenty-seven of the elderly meningioma patients were in good physical condition with minimal neurological involvement. They underwent total removal of the tumour at the first operation, and the histological diagnosis was benign. Twenty-five of these 27 patients fell into the best outcome category. Therefore, age alone was not a factor preventing proper surgical treatment of meningioma in the elderly.