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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Menigioma surgery in the elderly: Outcome and clinical radiological grading system (CRGS)

Operation von Meningiomen im fortgeschrittenen Lebensalter: Outcome und klinisch-radiologische Graduierung

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  • corresponding author D. Schul - Neurochirurgische Abteilung, Akademisches Krankenhaus München-Bogenhausen, Technische Universität München, Deutschland
  • S. Wolf - Neurochirurgische Abteilung, Akademisches Krankenhaus München-Bogenhausen, Technische Universität München, Deutschland
  • C. Lumenta - Neurochirurgische Abteilung, Akademisches Krankenhaus München-Bogenhausen, Technische Universität München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.01.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc040.shtml

Published: May 30, 2008

© 2008 Schul et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Meningiomas occur more frequently in the elderly and may pose a dilemma for the neurosurgeon in respect to the indication for operation. The small amount of published material (only 10 publications in Medline with the largest series of 96 patients) prompted us to retrospectively investigate our series taking into consideration the Clinical-Radiological Grading System (CRGS) proposed by Caroli et al and to correlate it with outcome.

Methods: We assessed the morbidity and mortality of meningioma surgery in 140 (105 female, 35 man) patients over the age 65 from 1995 to 2006. Data gathered included: patient age, sex, tumor site, symptoms and signs, perioperative complications, general health condition and pre- and post-operative neurologic status, CRGS Score, pre- and post-operative Karnofsky score, ASA Score and Simpson's Score.

Results: The group's mean age was 72,4 (range 65-87) years. 13 (9,3%) patients died. The median Karnofsky score improved from 80 to 90 postoperatively. Lower CRGS score correlated with worse outcome and higher mortality. CRGS <10 (6 patients), CRGS 10-12 (59 patients) and CRGS >12 (73 patients) showed mortality rates of 33% , 11% and 5% respectively (2,7 and 4 deceased patients in the corresponding groups, p<0.05). Age was an independent prognostic factor with 2 mortalities below 70 years (3%) and 11 mortalities above 70 years (14%).

Conclusions: Our results, which report on the largest patients study group to date, suggest that meningioma resection in the elderly is possible with few complications but with some mortality. Neurological outcome and mortality were similar to the published literature. The decision whether to operate should be discussed individually, combining the patient's age and the CRGS score.