gms | German Medical Science

The biology of tumours in the elderly differs from that of the young. Proliferation, vascularity and hormonal status in meningiomas presumable undergo changes in activity during the age. We try to provide insight into this phenomenon, detailing the immunohistochemical findings in the elderly, compared to younger meningioma patients.

Among 600 meningiomas from 554 patients examined immunohistochemically using the Mib-1 monoclonal antibody, 64 patients were older than 70 years. Patients with atypical or anaplastic tumours as well as NF-II disease were excluded from statistical analysis to achieve comparable groups. Proliferation index and progesteron-receptor (PR) status of the elderly were compared to the “young” patient group. Clinical charts including surgical records, discharge letters, histological records and imaging studies as well as meticulously focused questionnaires of clinical outcome were reviewed. Correlations with volume-progression of tumour, histological subtype, recurrence-free survival (F/U >34 month), grade of resection, location and osseous involvement were performed as well.

Compared to the “young” group of 443 meningioma patients, the elderly population (mean age 75.8, range 70-94) showed a female: male ratio of 4.2: 1. Mean Ki-67 LI (2.96 %; range 0-15%) and positive PR-status (46%) was significant lower. Total resection (Simpson °I-II) was achieved > 80%, four patients experienced recurrence (6 %, mean time of 20 month). Statistical analysis showed that tumours were larger (mean size on max. ap-diameter 15.1 cm²), less vascularized and showed more intratumoural calcifications.

Meningiomas in the population beyond 70 years differ biologically from the overall group of meningiomas. Less aggressive characteristics account for a slower growth and progression.