Murat Şakir Ekşi1, Çağrı Canbolat2, Ahmet Akbaş3, Berk Barış Özmen4, Ebubekir Akpınar3, Murat İmre Usseli5, Abuzer Güngör5, Mustafa Güdük5, Mehmet Hacıhanefioğlu6, Ayça Erşen Danyeli7, Koray Özduman5, M Necmettin Pamir5. 1. Department of Neurosurgery, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Istanbul, Turkey. Electronic address: muratsakireksi@gmail.com. 2. Vezirköprü State Hospital, Neurosurgery Clinic, Samsun, Turkey. 3. Department of Neurosurgery, Bakırköy Psychiatric Hospital, Health Sciences University, Istanbul, Turkey. 4. Medical Student, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Istanbul, Turkey. 5. Department of Neurosurgery, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Istanbul, Turkey. 6. Acıbadem Healthcare Group, Acıbadem Altunizade Hospital, Neurosurgery Clinic, Istanbul, Turkey. 7. Department of Pathology, Acıbadem Mehmet Ali Aydınlar University, School of Medicine, Istanbul, Turkey.
Abstract
BACKGROUND: Improved life expectancy and advanced diagnostic tools including computed tomography and magnetic resonance imaging have increased the awareness and diagnosis of intracranial meningiomas in the elderly population. The risk/benefit ratio of surgery in elderly patients with intracranial meningioma has not been clearly defined because of the lack of objective measurement tools. We aimed to understand the risk factors associated with postsurgical outcomes and how these risk factors affected postsurgical outcomes in elderly patients with intracranial meningioma. METHODS: We retrospectively evaluated 1372 patients, who were operated on for intracranial meningioma, using our prospectively collected database. The same senior author operated on all patients at 2 different tertiary clinics. Patients' clinical charts, presurgical postcontrast T1-weighted magnetic resonance images, operative reports, and pathology reports were reviewed. The relevant literature was also reviewed. RESULTS: Higher age, higher American Society of Anesthesiologists class, presence of comorbidities, tumor location, larger initial tumor size, and presence of peritumoral edema were all associated with postsurgical complications in elderly patients with intracranial meningioma. Age ≥50 years was the strongest predictor of postsurgical systemic complications, whereas higher American Society of Anesthesiologists class was the strongest predictor of postsurgical neurologic complications. A literature review showed higher morbidity and mortality of elderly patients with intracranial meningioma. Initial tumor size and postsurgical MIB-1 labeling index were higher in the elderly patients, both of which were predictors of tumor growth. CONCLUSIONS: Even though elderly patients operated on for intracranial meningioma had higher morbidity and mortality compared with younger patients, surgery is still much more beneficial than wait-and-see strategy in elderly patients.
BACKGROUND: Improved life expectancy and advanced diagnostic tools including computed tomography and magnetic resonance imaging have increased the awareness and diagnosis of intracranial meningiomas in the elderly population. The risk/benefit ratio of surgery in elderly patients with intracranial meningioma has not been clearly defined because of the lack of objective measurement tools. We aimed to understand the risk factors associated with postsurgical outcomes and how these risk factors affected postsurgical outcomes in elderly patients with intracranial meningioma. METHODS: We retrospectively evaluated 1372 patients, who were operated on for intracranial meningioma, using our prospectively collected database. The same senior author operated on all patients at 2 different tertiary clinics. Patients' clinical charts, presurgical postcontrast T1-weighted magnetic resonance images, operative reports, and pathology reports were reviewed. The relevant literature was also reviewed. RESULTS: Higher age, higher American Society of Anesthesiologists class, presence of comorbidities, tumor location, larger initial tumor size, and presence of peritumoral edema were all associated with postsurgical complications in elderly patients with intracranial meningioma. Age ≥50 years was the strongest predictor of postsurgical systemic complications, whereas higher American Society of Anesthesiologists class was the strongest predictor of postsurgical neurologic complications. A literature review showed higher morbidity and mortality of elderly patients with intracranial meningioma. Initial tumor size and postsurgical MIB-1 labeling index were higher in the elderly patients, both of which were predictors of tumor growth. CONCLUSIONS: Even though elderly patients operated on for intracranial meningioma had higher morbidity and mortality compared with younger patients, surgery is still much more beneficial than wait-and-see strategy in elderly patients.
Authors: Daniel Rueß; Vera Weyer; Juman Tutunji; Stefan Grau; Martin Kocher; Mauritius Hoevels; Harald Treuer; Christian Baues; Maximilian I Ruge Journal: Radiat Oncol Date: 2020-12-09 Impact factor: 3.481
Authors: Francesco Maiuri; Giuseppe Mariniello; Oreste de Divitiis; Felice Esposito; Elia Guadagno; Giuseppe Teodonno; Marcello Barbato; Marialaura Del Basso De Caro Journal: Front Oncol Date: 2021-07-15 Impact factor: 6.244