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Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome
Background Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection....
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| Published in: | Acta neurochirurgica 2015-09, Vol.157 (9), p.1549-1557 |
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| container_title | Acta neurochirurgica |
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| creator | Chen, Zhi-Yi Zheng, Chuan-Hua Tang Li Su, Xiao-Yan Lu, Gui-Hua Zhang, Chao-Yuan Xiao, Shao-Wen Tan, Yuan-Fu |
| description | Background
Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection.
Methods
Eighty-six patients (aged ≥65) diagnosed with an intracranial meningioma were surgically treated at our department. The clinical, radiological, and follow-up data were retrospectively reviewed. Univariate and multivariate logistic analyses were performed to identify relationships between factors [age, sex, neurological condition, concomitant disease, American Society of Anesthesiology (ASA) classification, preoperative Karnofsky Performance Scale (KPS) score, tumor location and size, peritumoral edema, and Simpson resection grade] and outcome.
Results
One patient (1.2 %) died within 30 days of surgery. The morbidity rate was 37.2 %. Postoperative morbidities occurred more frequently in the patients with preoperative neurological deficits than in those without (
p
= 0.049). Univariate analysis identified significant relationships between a low KPS score (≤70) at discharge and preoperative neurological deficits, low preoperative KPS score (≤70), and critical tumor location (
p
|
| doi_str_mv | 10.1007/s00701-015-2502-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1765978596</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3996442341</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-f050ac678fce30d42d70e3ea1c05d78447e978c87c565e8504a5660c4dd0c70d3</originalsourceid><addsrcrecordid>eNqNkc1q3TAQhUVoadK0D5BNEXSTLNyOZP3Y2YXQn0Cgm3YtVGl842BLiWQH7tvkWfJknXDTUAqFbkYS850zIw5jRwI-CAD7sVIB0YDQjdQgm36PHUCvZEMFXtAdqGuk6fbZ61qv6SWtal-xfWkECbv-gLmLtBQfik-jn_iMaUybMc-e17VssGz5mPhyhRyniGXa8uN8h4Ub_XC_RV_qySm_KXmTcl3GwAcfllwq9ynyvC4hz_iGvRz8VPHt03nIfnz-9P38a3P57cvF-dllExTopRlAgw_GdkPAFqKS0QK26EUAHW2nlMXedqGzQRuNnQbltTEQVIwQLMT2kB3vfGmd2xXr4uaxBpwmnzCv1QlrNDno3vwHSstA1xpJ6Pu_0Ou8lkQfIcpqLaRqW6LEjgol11pwcDdlnH3ZOgHuMSi3C8pRUO4xKNeT5t2T8_pzxvis-J0MAXIHVGoliuKP0f90_QXZK50i</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1775512433</pqid></control><display><type>article</type><title>Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome</title><source>Springer Link</source><creator>Chen, Zhi-Yi ; Zheng, Chuan-Hua ; Tang Li ; Su, Xiao-Yan ; Lu, Gui-Hua ; Zhang, Chao-Yuan ; Xiao, Shao-Wen ; Tan, Yuan-Fu</creator><creatorcontrib>Chen, Zhi-Yi ; Zheng, Chuan-Hua ; Tang Li ; Su, Xiao-Yan ; Lu, Gui-Hua ; Zhang, Chao-Yuan ; Xiao, Shao-Wen ; Tan, Yuan-Fu</creatorcontrib><description>Background
Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection.
Methods
Eighty-six patients (aged ≥65) diagnosed with an intracranial meningioma were surgically treated at our department. The clinical, radiological, and follow-up data were retrospectively reviewed. Univariate and multivariate logistic analyses were performed to identify relationships between factors [age, sex, neurological condition, concomitant disease, American Society of Anesthesiology (ASA) classification, preoperative Karnofsky Performance Scale (KPS) score, tumor location and size, peritumoral edema, and Simpson resection grade] and outcome.
Results
One patient (1.2 %) died within 30 days of surgery. The morbidity rate was 37.2 %. Postoperative morbidities occurred more frequently in the patients with preoperative neurological deficits than in those without (
p
= 0.049). Univariate analysis identified significant relationships between a low KPS score (≤70) at discharge and preoperative neurological deficits, low preoperative KPS score (≤70), and critical tumor location (
p
< 0.001,
p
< 0.001, and
p
= 0.04, respectively). In the multivariate logistic analysis, only the preoperative KPS score remained significant for the KPS score at discharge (
p
= 0.005); there was no significant association with the most recent KPS score.
Conclusion
The outcome of intracranial meningioma resection in elderly individuals is favorable if the preoperative KPS score is >70 and no neurological deficits are present. Treatment decisions should be patient-specific, and additional factors should be considered when operations are performed in patients with a low preoperative KPS score or neurological deficits.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-015-2502-9</identifier><identifier>PMID: 26170189</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Age Factors ; Aged ; Clinical Article - Brain Tumors ; Female ; Humans ; Interventional Radiology ; Male ; Medicine ; Medicine & Public Health ; Meningeal Neoplasms - surgery ; Meningioma - surgery ; Minimally Invasive Surgery ; Neurology ; Neuroradiology ; Neurosurgery ; Neurosurgical Procedures - adverse effects ; Neurosurgical Procedures - statistics & numerical data ; Surgical Orthopedics ; Survival Analysis</subject><ispartof>Acta neurochirurgica, 2015-09, Vol.157 (9), p.1549-1557</ispartof><rights>Springer-Verlag Wien 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-f050ac678fce30d42d70e3ea1c05d78447e978c87c565e8504a5660c4dd0c70d3</citedby><cites>FETCH-LOGICAL-c405t-f050ac678fce30d42d70e3ea1c05d78447e978c87c565e8504a5660c4dd0c70d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26170189$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Zhi-Yi</creatorcontrib><creatorcontrib>Zheng, Chuan-Hua</creatorcontrib><creatorcontrib>Tang Li</creatorcontrib><creatorcontrib>Su, Xiao-Yan</creatorcontrib><creatorcontrib>Lu, Gui-Hua</creatorcontrib><creatorcontrib>Zhang, Chao-Yuan</creatorcontrib><creatorcontrib>Xiao, Shao-Wen</creatorcontrib><creatorcontrib>Tan, Yuan-Fu</creatorcontrib><title>Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Background
Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection.
Methods
Eighty-six patients (aged ≥65) diagnosed with an intracranial meningioma were surgically treated at our department. The clinical, radiological, and follow-up data were retrospectively reviewed. Univariate and multivariate logistic analyses were performed to identify relationships between factors [age, sex, neurological condition, concomitant disease, American Society of Anesthesiology (ASA) classification, preoperative Karnofsky Performance Scale (KPS) score, tumor location and size, peritumoral edema, and Simpson resection grade] and outcome.
Results
One patient (1.2 %) died within 30 days of surgery. The morbidity rate was 37.2 %. Postoperative morbidities occurred more frequently in the patients with preoperative neurological deficits than in those without (
p
= 0.049). Univariate analysis identified significant relationships between a low KPS score (≤70) at discharge and preoperative neurological deficits, low preoperative KPS score (≤70), and critical tumor location (
p
< 0.001,
p
< 0.001, and
p
= 0.04, respectively). In the multivariate logistic analysis, only the preoperative KPS score remained significant for the KPS score at discharge (
p
= 0.005); there was no significant association with the most recent KPS score.
Conclusion
The outcome of intracranial meningioma resection in elderly individuals is favorable if the preoperative KPS score is >70 and no neurological deficits are present. Treatment decisions should be patient-specific, and additional factors should be considered when operations are performed in patients with a low preoperative KPS score or neurological deficits.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Clinical Article - Brain Tumors</subject><subject>Female</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meningeal Neoplasms - surgery</subject><subject>Meningioma - surgery</subject><subject>Minimally Invasive Surgery</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Neurosurgical Procedures - statistics & numerical data</subject><subject>Surgical Orthopedics</subject><subject>Survival Analysis</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqNkc1q3TAQhUVoadK0D5BNEXSTLNyOZP3Y2YXQn0Cgm3YtVGl842BLiWQH7tvkWfJknXDTUAqFbkYS850zIw5jRwI-CAD7sVIB0YDQjdQgm36PHUCvZEMFXtAdqGuk6fbZ61qv6SWtal-xfWkECbv-gLmLtBQfik-jn_iMaUybMc-e17VssGz5mPhyhRyniGXa8uN8h4Ub_XC_RV_qySm_KXmTcl3GwAcfllwq9ynyvC4hz_iGvRz8VPHt03nIfnz-9P38a3P57cvF-dllExTopRlAgw_GdkPAFqKS0QK26EUAHW2nlMXedqGzQRuNnQbltTEQVIwQLMT2kB3vfGmd2xXr4uaxBpwmnzCv1QlrNDno3vwHSstA1xpJ6Pu_0Ou8lkQfIcpqLaRqW6LEjgol11pwcDdlnH3ZOgHuMSi3C8pRUO4xKNeT5t2T8_pzxvis-J0MAXIHVGoliuKP0f90_QXZK50i</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Chen, Zhi-Yi</creator><creator>Zheng, Chuan-Hua</creator><creator>Tang Li</creator><creator>Su, Xiao-Yan</creator><creator>Lu, Gui-Hua</creator><creator>Zhang, Chao-Yuan</creator><creator>Xiao, Shao-Wen</creator><creator>Tan, Yuan-Fu</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20150901</creationdate><title>Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome</title><author>Chen, Zhi-Yi ; Zheng, Chuan-Hua ; Tang Li ; Su, Xiao-Yan ; Lu, Gui-Hua ; Zhang, Chao-Yuan ; Xiao, Shao-Wen ; Tan, Yuan-Fu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-f050ac678fce30d42d70e3ea1c05d78447e978c87c565e8504a5660c4dd0c70d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Clinical Article - Brain Tumors</topic><topic>Female</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meningeal Neoplasms - surgery</topic><topic>Meningioma - surgery</topic><topic>Minimally Invasive Surgery</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures - adverse effects</topic><topic>Neurosurgical Procedures - statistics & numerical data</topic><topic>Surgical Orthopedics</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Zhi-Yi</creatorcontrib><creatorcontrib>Zheng, Chuan-Hua</creatorcontrib><creatorcontrib>Tang Li</creatorcontrib><creatorcontrib>Su, Xiao-Yan</creatorcontrib><creatorcontrib>Lu, Gui-Hua</creatorcontrib><creatorcontrib>Zhang, Chao-Yuan</creatorcontrib><creatorcontrib>Xiao, Shao-Wen</creatorcontrib><creatorcontrib>Tan, Yuan-Fu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Zhi-Yi</au><au>Zheng, Chuan-Hua</au><au>Tang Li</au><au>Su, Xiao-Yan</au><au>Lu, Gui-Hua</au><au>Zhang, Chao-Yuan</au><au>Xiao, Shao-Wen</au><au>Tan, Yuan-Fu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>157</volume><issue>9</issue><spage>1549</spage><epage>1557</epage><pages>1549-1557</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Background
Meningiomas are more prevalent in elderly individuals; however, the surgical outcome and prognostic factors in this age group are unclear. This retrospective study aimed to identify the prognostic factors of elderly patients with intracranial meningiomas who underwent surgical resection.
Methods
Eighty-six patients (aged ≥65) diagnosed with an intracranial meningioma were surgically treated at our department. The clinical, radiological, and follow-up data were retrospectively reviewed. Univariate and multivariate logistic analyses were performed to identify relationships between factors [age, sex, neurological condition, concomitant disease, American Society of Anesthesiology (ASA) classification, preoperative Karnofsky Performance Scale (KPS) score, tumor location and size, peritumoral edema, and Simpson resection grade] and outcome.
Results
One patient (1.2 %) died within 30 days of surgery. The morbidity rate was 37.2 %. Postoperative morbidities occurred more frequently in the patients with preoperative neurological deficits than in those without (
p
= 0.049). Univariate analysis identified significant relationships between a low KPS score (≤70) at discharge and preoperative neurological deficits, low preoperative KPS score (≤70), and critical tumor location (
p
< 0.001,
p
< 0.001, and
p
= 0.04, respectively). In the multivariate logistic analysis, only the preoperative KPS score remained significant for the KPS score at discharge (
p
= 0.005); there was no significant association with the most recent KPS score.
Conclusion
The outcome of intracranial meningioma resection in elderly individuals is favorable if the preoperative KPS score is >70 and no neurological deficits are present. Treatment decisions should be patient-specific, and additional factors should be considered when operations are performed in patients with a low preoperative KPS score or neurological deficits.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>26170189</pmid><doi>10.1007/s00701-015-2502-9</doi><tpages>9</tpages></addata></record> |
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| language | eng |
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| subjects | Age Factors Aged Clinical Article - Brain Tumors Female Humans Interventional Radiology Male Medicine Medicine & Public Health Meningeal Neoplasms - surgery Meningioma - surgery Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Neurosurgical Procedures - adverse effects Neurosurgical Procedures - statistics & numerical data Surgical Orthopedics Survival Analysis |
| title | Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome |
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