gms | German Medical Science

Between 1992 and 2001, 769 patients with meningiomas have been treated surgically at our institution. Among those we found 11 patients older than 80 years. To answer the question whether it is worthwhile to treat meningiomas in these patients, we analysed clinical data, the benefit/risk ratio and the operative results in this subgroup.

We focused on the indication of the treatment, clinical findings and the outcome of this group, comparing the Karnofski score (KS) as an indicator for pre- and postoperative neurological status at the time of discharge.

There were 7 female and 4 male (ratio 1,8:1) patients with a mean age of 82.1 years, the oldest patient was 85 years old. One of the tumours was located at the cerebellar convexity, the other ten at the supratentorial region. Eight of those were primary findings, the other three were recurrences. All of the patients were symptomatic by the time of admission. The most common symptom leading to the diagnosis was central paresis in 7 cases, followed by seizures in 2 cases, proptosis and ataxia in one case each. The Karnofski scale ranged between 60 and 90 (mean: 80) at this time. The highest grade of tumour removal was Simpson II (in 6 patients; 2 cases of grade III, three of grade IV). No surgical complication occurred among the whole population, neither there was perioperative mortality. Histological findings confirmed the diagnosis in all cases with four of the tumours belonging to the subgroupof atypical menigiomas. By the time of discharge we confirmed a mean score of 74 points on the KS. This was due to the worsening of the paresis in 1 case, this patient and other two suffered from transient neuropsychologic disorder. Nevertheless we achieved an equal or improved life quality according to the KS in 8 cases.

Regarding the outcome of this population and our operative results it seems to be favourable to treat meningiomas surgically in carefully selected patients even in this age group.