Surgical outcome in an elderly population with intracranial meningioma.
Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial meningioma who had craniotomy between the years 1978-88 were reviewed. There were 20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%) cases and each tumour was histologically verified. The location of the tumours were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1. The most frequent associated diseases were: hypertension (35%), chronic ischaemic heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean = 59). It was less than 40 in ten patients. The length of anaesthesia during the surgical procedure varied from 4 to 12 hours and was not related to the outcome. There were two perioperative deaths (mortality = 5.4%). There were major complications in 8 patients and minor complications in 7 patients. In a mean follow up period of 29 months (shortest 6 and longest 96 months) the results were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59) and the mean postoperative KS value (KS = 80) was statistically significant (P less than 0.001). The results support a more aggressive therapeutic approach to the elderly patient with an intracranial meningioma.
Umansky
F
F
Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.
Ashkenazi
E
E
Gertel
M
M
Shalit
M N
MN
D000368:Aged; D000771:Anesthesia, Intravenous; D001921:Brain / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013502:General Surgery; D005853:Geriatrics; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008579:Meningioma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*