[Intracranial meningioma in the elderly. Postoperative mortality, morbidity and quality of life in a series of 39 patients over 70 years of age].
The aim of this study was to assess the current morbidity and mortality in patients over 70 operated for intracranial meningioma.


METHODS
We report a series of 39 consecutive patients (mean age: 73 y) operated for an intracranial meningioma over a period of 5 years (1990-1994). According to the Karnofski scale (KS), preoperative neurological status was inferior or equal to 70 in 21 patients (53.8%) and superior or equal to 80 in 18 (46.2%). All patients were followed up in order to precisely assess their post-operative condition and a computed tomographic scan (CT scan) was performed during the second semester of 1995 (mean follow-up 29 months).


RESULTS
Operative mortality and permanent morbidity were respectively 7.6% and 10.3%. In 77% of this series, the KS score checked at the last follow up was 80 to 100 (good outcome). Poor outcome was defined by death or a postoperative (KS < or = 70, the principal cause being an hemorrhagic infarction. Three factors were predictors of poor outcome: poor preoperative neurological condition (KS < or = 70) (p = 0.07), location of the tumor on the base (p = 0.007), and the duration of surgery > 3 hours (p = 0.06). The logistical regression analysis showed that these three factors were independent. Tumor recurrence occurred in 5 (12.8%) of 39 patients.


CONCLUSIONS
Preoperative KS is a prognosis factor, but a poor preoperative condition is not in itself a sufficient condition contraindicating surgery. The rates of operative mortality of 7.6%, and permanent operative morbidity of 10.3% can be given to patients and their families.
Proust
F
F
Service de Neurochirurgie, Hôpital Charles-Nicolle, Rouen.
Verdure
L
L
Toussaint
P
P
Bellow
F
F
Callonec
F
F
Menard
J F
JF
Fréger
P
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D011788:Quality of Life