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Thirty-seven cases of intracranial meningiomas in the
ninth decade of life: our experience and review of the literature
D'Andrea G, Roperto R, Caroli E, Crispo F, Ferrante L
Department of Neurosurgery, University of Rome La Sapienza, II Faculty of
Medicine, S. Andrea Hospital, Rome, Italy. gdandrea2002@yahoo.it
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).
Conclusion. 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.
PMID: 15854243 [PubMed - in process]
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