Journal of Neurosurgical Sciences 2018 May 28

DOI: 10.23736/S0390-5616.18.04333-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Outcome of elderly patients undergoing intracranial meningioma resection: a single center experience

Cesare ZOIA ¹, Daniele BONGETTA ¹, Francesco GUERRINI ¹ ✉, Cristiano ALICINO ³, Andrea CATTALANI ¹, Simonetta BIANCHINI ¹, Renato J. GALZIO ¹, Sabino LUZZI ^{1, 3}

¹ Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy; ² Department of Health Sciences, University of Genoa, Genoa, Italy; ³ Department of Emergency and Organ Transplantation, University Aldo Moro, Bari, Italy

BACKGROUND: Higher life expectancy and higher mean age in general population created growing interest in medical and surgical management of meningiomas in elderly. It is well known that, due to possible complications, pre-operative status and comorbidities, expecially in aged people, should be carefully considerated in the decision-making process. We described our experience with this kind of patients and analized the influence of complications on the outcome.
METHODS: We conducted a monocentric retrospective study to evaluate outcome and complications in elderly patients that underwent intracranial meningioma surgery in our center in a ten year period. Between January 2005 and December 2014, 107 patients - older than 70 years old - were operated for an intracranial meningioma. We excluded patients operated for a recurrent meningioma. We use the Dindo classification modified by Poon to describe complications and the Karnofsky Performance Status Scale and Glasgow Outcome Scale to evaluate the outcome at discharge and after a 6 months period.
RESULTS: 84 patients did not have postoperative complications, 10 patients had mild postoperative complications, while 13 patients suffered severe postoperative complications. As a group, patients with mild complications presented, six months after surgery, an average Karnofsky Performance Status better than preoperative one.
CONCLUSIONS: Even though the fragility is considered an important risk factor, surgery for symptomatic intracranial meningiomas should be considered also in elderly patients. The presence of early postoperative mild complications do not seem to worsen the average 6 months- KSP score.

KEY WORDS: Meningioma - Elderly - Outcome - Complications