Brain tumor surgery in geriatric patients: a critical analysis in 44 patients over 80 years

Pietilä, Terttu; Stendel, Ruediger; Hassler, Werner; Heimberger, Carin; Ramsbacher, Josef; Brock, M.

doi:10.1016/s0090-3019(99)00075-0

Cited by 18 publications

(21 citation statements)

References 17 publications

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“…26,36 We found a mortality rate of 1.8%, similar to the reports in previous adult pituitary surgery series. 5,34 Although associated with a higher incidence in patients categorized as ASA 3, no significant mortality difference was observed in our study. We believe that adequate preoperative planning and patient selection, careful surgical technique, and rigorous postoperative care are responsible for such low rates of mortality, even in high-risk patients.…”

Section: Discussioncontrasting

confidence: 72%

“…34 Although elderly patients usually present a significant number of comorbidities and higher odds of postoperative complications when undergoing neurosurgical procedures, those with visual or neurological alterations or with symptoms secondary to hormonal dysfunction should be considered for surgical treatment. 21,24 Previous studies have analyzed the outcomes in elderly patients who undergo transsphenoidal surgery for removal of PA, demonstrating the benefits of this approach in selected patients.…”

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confidence: 99%

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Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas

Gondim¹,

Almeida

Albuquerque

et al. 2015

JNS

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Endoscopic transsphenoidal surgery for elderly patients with PAs may be associated with higher complication rates, especially secondary to early transitory complications, when compared with surgery performed in younger patients. Although the worst preoperative clinical status might be observed in this group, age alone is not associated with a worst final prognosis after endoscopic removal of nonfunctioning PAs.

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Section: Discussioncontrasting

confidence: 72%

mentioning

confidence: 99%

Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas

Gondim¹,

Almeida

Albuquerque

et al. 2015

JNS

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“…Preoperative cerebrovascular conditioning and the existence of multiple preoperative concomitant diseases were important determining factors for the occurrence of postoperative complications. 35 …”

Section: Discussionmentioning

confidence: 99%

“…25,35 However, for the first time, base on multi-institutional data, we define an age cutoff for worse outcome following neurosurgical resection of brain metastases.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Inpatient Death and Complications among Postoperative Elderly Patients with Metastatic Brain Tumors

et al. 2010

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Objective Risks of brain surgery in elderly patients with brain metastases are not well defined. This study was designed to quantify the postoperative risk for these patients after brain surgery for metastatic disease to the brain. Methods We performed a retrospective analysis of the Nationwide Inpatient Sample (1998–2005). Patients aged 65 years or older who underwent tumor resection of brain metastases were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included systemic postoperative complications, length of stay (LOS), and total charges. Results A total of 4,907 patients (53.6% men) were identified. Mean age was 72.1 years. Mean Charlson comorbidity score was 7.8. Inpatient mortality was 4%. The most common adverse events were pulmonary complications (3.4%). Mean length of stay was 9.2 days. Mean total charges were $57,596.39. In multivariate analysis, patients up to age 80 years had no significantly greater odds of inpatient death, relative to their 65- to 69-year-old counterparts. Each 1-point increase in Charlson score was associated with 12% increased odds of death, 0.52 days increased LOS, and $1,710.61 higher hospital charges. Postoperative pulmonary complications, stroke, or thromboembolic events increased LOS and total charges by up to 9.6 days and $57,664.42, respectively. These associations were statistically significant (P < 0.05). Conclusions Surgical resection of brain metastases among the elderly up to the ninth decade of life is feasible. Age older than 80 years and higher Charlson comorbidity scores were found to be important prognostic factors for inpatient outcome. Incorporating these factors into preoperative decision making may help to select appropriately those elderly candidates for neurosurgical intervention.

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“…In a German series of 44 brain tumor patients (≥80 years), 43% improved after surgery, 34% remained stable and 23% worsened; the perioperative mortality was 11% [26]. Concomitant cerebrovascular and systemic chronic diseases were clearly associated with a poorer outcome, unlike tumor location and volume.…”

Section: Surgerymentioning

confidence: 99%

Glioblastoma in the elderly: Current and future trends

Brandes

Compostella

Blatt

et al. 2006

Critical Reviews in Oncology/Hematology

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Brain tumor surgery in geriatric patients: a critical analysis in 44 patients over 80 years

Cited by 18 publications

References 17 publications

Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas

Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas

Predictors of Inpatient Death and Complications among Postoperative Elderly Patients with Metastatic Brain Tumors

Glioblastoma in the elderly: Current and future trends

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