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  • Title: Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature.
    Author: D'Andrea G, Roperto R, Caroli E, Crispo F, Ferrante L.
    Journal: Neurosurgery; 2005 May; 56(5):956-61; discussion 956-61. PubMed ID: 15854243.
    Abstract:
    OBJECTIVE: We report a series of 37 elderly patients who were surgically treated for intracranial meningioma in the ninth decade of life at our neurosurgical division between 1985 and 2002. METHODS: Our study included 37 patients ranging in age from 80 to 86 years (29 women, 8 men). The preoperative neurological status was evaluated according to Karnofsky Performance Scale (KPS) status. The patients' general health condition was evaluated according to the American Society of Anesthesiology (ASA) classification. RESULTS: Five patients (13.5%) experienced perioperative mortality. The risk of postoperative mortality was higher in patients graded as ASA Class III who had low preoperative KPS ratings (< 70), whereas it was lower in patients graded as ASA Classes I and II (P > 0.001). The postoperative mortality rate was significantly higher in patients graded as having a KPS score of less than 70 (P > 0.01). The risk of postoperative morbidity seems higher with larger maximum tumor diameters (P < 0.05). Surgical excision and the presence of a severe peritumoral edema seem to be associated with a higher risk of postoperative morbidity (P < 0.05). CONCLUSION: Surgical removal of a meningioma in the elderly is a safe procedure if the preoperative ASA classification is I or II and if the KPS rating is at least 70. Age seems not to be an insuperable obstacle when adequate management of all risk factors has been obtained.
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