Minimally invasive surgical treatment of intracranial meningiomas in elderly patients (≥ 65 years): outcomes, readmissions, and tumor control
Jai Deep Thakur, MD, Regin Jay Mallari, BS, Alex Corlin, BA, Samantha Yawitz, Weichao Huang, MD, Amy Eisenberg, MSN, ARNP, CNRN, Walavan Sivakumar, MD, Howard R. Krauss, MD, Chester Griffiths, MD, Garni Barkhoudarian, MD, and Daniel F. Kelly, MD
Neurological Focus. 2020 Oct 1.
Increased lifespan has led to more elderly patients being diagnosed with meningiomas. In this study, the authors sought to analyze and compare patients ≥ 65 years old with those In a retrospective analysis, consecutive patients with meningiomas who underwent minimally invasive (endonasal, supraorbital, minipterional, transfalcine, or retromastoid) and conventional surgical treatment approaches during the period from 2008 to 2019 were dichotomized into those ≥ 65 and those Of 291 patients (median age 60 years, 71.5% females, mean follow-up 36 months) undergoing meningioma resection, 118 (40.5%) were aged ≥ 65 years and underwent 126 surgeries, including 20% redo operations, as follows: age 65–69 years, 46 operations; 70–74 years, 40 operations; 75–79 years, 17 operations; and ≥ 80 years, 23 operations. During 2015–2019, of 98 patients referred for meningioma, 67 (68%) had surgery, 1 (1%) had radiosurgery, and 31 (32%) were observed. In the 11-year surgical cohort, comparing 173 patients This analysis suggests that elderly patients with meningiomas, when carefully selected, generally have excellent surgical outcomes and tumor control. When applied appropriately, use of minimally invasive approaches and endoscopy may be helpful in achieving maximal safe resection, reducing complications, and promoting short hospitalizations. Notably, one-third of our elderly meningioma patients referred for possible surgery from 2015 to 2019 were managed nonoperatively.
Keywords: meningioma; elderly; intracranial; tumor; endoscopic; keyhole
ABBREVIATIONS ASA = American Society of Anesthesiologists; EBL = estimated blood loss; GTR = gross-total resection; KPS = Karnofsky Performance Status; LOS = length of hospital stay; NTR = near-total resection; SRS = stereotactic radiosurgery; STR = subtotal resection.
Intracranial meningiomas are the most common primary brain tumor, and in most adult surgical series, almost half of meningioma patients are ≥ 65 years old.1 Secondary to improved life