Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature.
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).


CONCLUSIONS
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.
D'Andrea
Giancarlo
G
Department of Neurosurgery, University of Rome La Sapienza, II Faculty of Medicine, S. Andrea Hospital, Rome, Italy. gdandrea2002@yahoo.it
Roperto
Raffaelino
R
Caroli
Emanuela
E
Crispo
Francesco
F
Ferrante
Luigi
L
D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D019990:Perioperative Care / Q000401:mortality; D011446:Prospective Studies; D016019:Survival Analysis