Comparison of outcomes of surgery for intracranial meningioma in elderly and young patients – A systematic review and meta-analysis

• Published in: Clinical neurology and neurosurgery 2021-08, Vol.207, p.106772-106772, Article 106772
• Main Authors: Rafiq, Rahil, Katiyar, Varidh, Garg, Kanwaljeet, Kasliwal, Manish, Chandra, P.Sarat, Kale, Shashank S.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Age groups; Aged; Brain cancer; Brain Neoplasms - surgery; Comorbidity; Diabetes; Edema; Elderly; Hemorrhage; Humans; Hypertension; Intracranial; Length of stay; Life span; Meningeal Neoplasms - surgery; Meningioma; Meningioma - surgery; Meta-analysis; Middle Aged; Morbidity; Mortality; Neurological complications; Neurology; Neurosurgery; Older people; Patients; Radiosurgery; Surgery; Systematic review; Treatment Outcome
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2021.106772

The proportion of elderly patients with intracranial meningiomas is increasing as the life expectancy has improved. Increasing age is classically believed to be associated with higher perioperative morbidity and mortality in neurosurgical patients. We performed a systematic literature search in ‘PUBMED’ and ‘EMBASE’ databases and reviewed all the studies comparing outcomes of surgery between young and elderly patients with intracranial meningiomas (IM). Data related to 3-month mortality rates, length of hospital stay and complications, preoperative status and comorbidity, meningioma size, location, histology, peritumoral edema, and grade of excision were extracted and analyzed. Thirteen retrospective studies fulfilled the eligibility criteria out of the 893 reviewed articles. Pooled analysis showed that the 3-month mortality rate (4.65% versus 1.42%) and length of stay (10d versus 6.8d) for elderly patients were significantly higher as compared to the young population. The rates of cardio-respiratory complications (16.3% v/s 8.3%), intracranial hemorrhage (10.2% v/s 4.2%) and new-onset neurologic deficit (20.7% v/s 10.1%) were also significantly high in the elderly group as compared to the young patients. Moreover, a higher prevalence of associated comorbidities and poor performance score was noted in the elderly patients of IM. The overall mortality rate and rates of perioperative complications (cardio-respiratory, neurologic, intracranial hemorrhage) after surgery in elderly patients with IM patients are higher as compared to young patients and should be kept in mind when formulating treatment strategy for IM in this patient population. •The mortality rate and length of stay for elderly meningioma patients are significantly higher.•The rates of peri-operative complications after surgery in elderly patients are higher.•All these factors should be kept in mind when individualizing treatment strategy.