Surgical treatment and outcome in patients over 80 years old with intracranial meningioma

Abstract

ObjectiveStudy of mortality rate and clinical outcomes in octogenarians patients operated for intracranial meningiomas. Patients and methodsClinical, radiological and surgical data of 25 elderly patients aging over 80 years old operated at our Department from 2013 to 2016 for intracranial meningiomas have been recorded and analyzed. One-month mortality and clinical outcome at six-months after surgery were evaluated. Logistic regression was used for detecting the risk factors influencing mortality and neurological functions. ResultsThe median age at diagnosis was 8185 years (range 80–87). Meningiomas were gross-total removed in 18 cases out of 25 (72%) and partially resected in 7 (28%).One-month post-operative mortality occurred in 2 pts out of 25 (8%). A close correlation was found between operative duration over 240 min and mortality (p = 0,0421). There was a significantly lower mortality in patients with ASA II rather than in patients with ASA III (p = 0,038).The median pre-operative KPS value was 743 (range 50–90) while at six-month follow-up was 82.The surgical time (p = 00,006) and size of the lesion >4 cm (p = 002) were a significant prognostic factors for clinical improvement at six-month follow-up. ConclusionsThe operative time and the ASA score are the most important prognostic factors for the mortality and neurological outcome of elderly patients over 80 years old operated for intracranial meningioma. Even if the number of patients is limited, our findings suggest that, after a careful preoperative stratification in elderly patients, it is possible to remove an intracranial meningioma with good results.