Meningiomas in the elderly, the surgical benefit and a new scoring system

Cohen-Inbar, Or; Soustiel, Jean F.; Zaaroor, Menashe

doi:10.1007/s00701-009-0552-6

Cited by 73 publications

(52 citation statements)

References 10 publications

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“…Several studies have assessed predictors for surgical outcome in elderly meningioma patients using CRGS, GSS and SKALE scoring systems that include tumor size, gender, KPS score, ASA score, tumor location, peritumoral edema and concomitant disease (9,10,16). The CRGS, GSS and SKALE scoring systems have been proposed for use in patients aged over 70, 65 and 80 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies demonstrated that a poor outcome following surgical treatment for intracranial meningiomas in the elderly was associated with a score ≤9, ≤15 and ≤7 for the CRGS, GSS and SKALE, respectively (15)(16)(17). The cut-off point for postoperative complications was ≤9, ≤15, and ≤7 for CRGS, GSS, and SKALE, respectively (9,15,17). Multivariate logistic regression analysis revealed no significant associations between patient age (≥75 years), lower CRGS (≤9), GSS (≤15), and SKALE scores (≤7) and surgical complications (P= 0.0992, P= 0.7935, P= 0.1414 and P= 0.6441, respectively) (Table IV).…”

Section: ------------------------------------------------------------mentioning

confidence: 92%

“…Tumor resection rate was determined according to the Simpson grade (18) and tumors were pathologically graded according to the World Health Organization (WHO) classification (19). In addition, proposed grading scoring systems, including CRGS, GSS, and SKALE, were used to calculate scores for each patient using admission data, according to previous studies (9,15,17) and the correlation between these scores and surgical outcomes was assessed.…”

Section: Methodsmentioning

confidence: 99%

“…Thus, an increasing number of intracranial meningiomas are identified incidentally (4,5). However, few studies have reported the outcome of surgical resection of intracranial meningiomas in the elderly (6)(7)(8)(9)(10). Clinically, it is often difficult for physicians to determine whether traditional surgical resection is the optimal management strategy for meningioma in elderly patients: Due to their aging physiology and multiple comorbidities, elderly patients are potentially at risk of unexpected or even life-threatening surgical complications (7,8).…”

Section: Introductionmentioning

confidence: 99%

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Clinical features and surgical management of intracranial meningiomas in the elderly

et al. 2017

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Abstract. Meningioma accounts for ~25% of all primary intracranial neoplasms and the incidence increases with age. Prvios population-based studies demonstrated that the annual incidence of intracranial meningiomas was 1.2-3.1/100,000 population. In particular, the incidence of this disease among the elderly is high. Recently, increased life expectancy and greater use of diagnostic radiological imaging led to an increased incidence in the diagnosis of intracranial meningiomas, both symptomatic and asymptomatic, in the elderly. Thus, neurosurgeons may be increasingly confronted with the management of intracranial meningiomas in the elderly. In practice, it is often difficult for physicians to determine whether traditional surgical resection is the optimal management strategy for intracranial meningiomas in the elderly. However, reported clinical studies about the outcome of surgical resection of intracranial meningiomas in the elderly are limited. Increased risk of mortality and morbidity associated with surgical treatment for intracranial meningiomas in the elderly compared with younger patients have been controversial. In the present study, the clinical features of intracranial meningiomas in 70 consecutive intracranial meningioma patients that underwent surgical treatment at the affiliated hospital of University of Occupational and Environmental Health between 2007 and 2013 were assessed. In addition, patient selection and surgical management of intracranial meningioma in elderly patients was discussed. Preoperative factors, including symptoms, tumor location, tumor size, Karnofsky Performance Scale (KPS) score and American Society of Anesthesiology (ASA) score, and postoperative factors, including pathological diagnosis, tumor proliferation index (Ki-67), resection rate (Simpson grade), length of hospital stay and discharge destination were retrospectively analyzed in patients aged ≥75 years (n=16; elderly group) and <75 years (n=54; younger group). Outcomes were assessed 6 months after surgery. Multivariate logistic regression revealed that tumor resection rate (Simpson grade III-V) was an important predictor of surgical complications (odds ratio, 5.662; 95% confidence interval, 1.323-24.236; P= 0.0194). Perioperative morbidity was not correlated with age (>75 years), tumor location, tumor size, KPS score or ASA score. Thus, the present study indicated that age is not associated with surgical outcome in elderly meningioma patients. Regardless of patient age, the decision to perform surgical resection should be made on an individual basis wherein tumor characteristics and the general health of the patient are considered.

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Section: Discussionmentioning

confidence: 99%

Section: ------------------------------------------------------------mentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical features and surgical management of intracranial meningiomas in the elderly

et al. 2017

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“…After screening of the title and abstract, 1377 irrelevant studies were excluded. Then, three studies were excluded for irrelevant outcomes [26][27][28] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

Prognostic Significance of Hyperglycemia in Patients with Brain Tumors: a Meta-Analysis

Liu

Jiang

et al. 2015

Mol Neurobiol

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Hyperglycemia has been associated with poor outcomes of patients with various diseases. There were several studies published to assess the association between hyperglycemia and prognosis of patients with brain tumors, but no consistent conclusion was available. We therefore performed a meta-analysis of available studies to evaluate the prognostic role of hyperglycemia in brain tumors. Several common databases were searched for eligible studies on the association between hyperglycemia and survival of patients with brain tumors. Two investigators used a set of predefined inclusion criteria to assess eligible studies independently. The pooled hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the prognostic role of hyperglycemia. Finally, seven studies with a total of 2168 patients with brain tumors were included into the meta-analysis. Meta-analysis of total seven studies showed that hyperglycemia was significantly associated with shorter overall survival of brain tumors (HR = 2.04, 95% CI 1.51-2.76, P < 0.001). Meta-analysis of studies focusing on hyperglycemia showed that hyperglycemia was still significantly associated with shorter overall survival of brain tumors (HR = 1.82, 95% CI 1.29-2.59, P = 0.001). Meta-analysis of three studies on diabetes showed that diabetes was significantly associated with shorter overall survival of brain tumors (HR = 2.09, 95% CI 1.22-3.57, P = 0.007). Meta-regression analysis showed that there was no obvious difference in the roles of between hyperglycemia caused by glucocorticoids and hyperglycemia from diabetes (P = 0.25). Thus, hyperglycemia has an obvious prognostic significance in patients with brain tumors, and hyperglycemia is significantly associated with shorter overall survival of brain tumors.

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Incidence and survival of benign, borderline, and malignant meningioma patients in the United States from 2004 to 2018

Cao

Yan

et al. 2022

Intl Journal of Cancer

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Meningioma is the most common primary central nervous system tumor, and its incidence is increasing. A systematic epidemiological and clinical analysis is required to better estimate its public health impact and understand its prognostic factors. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2018 for all types of meningiomas without an age restriction.Age-adjusted incidence rates (IRs) and 95% confidence intervals were estimated according to sex, age, race, ethnicity, and tumor location. Kaplan-Meier analysis and multivariate Cox proportional hazard models were used to analyze the overall survival (OS). The competing risk regression model of Fine-Gray was used to analyze cause-specific survival. Data from a total of 109 660 meningioma patients were analyzed. A majority of patients were older than 60 years, and only 0.41% of patients were 0-19 years. The meningioma IRs were higher in females, Black, and non-Hispanic patients than in males, White, and Hispanic patients, respectively, and IRs increased with age. The ratio of IRs for females to males was 2.1 and also increased with age, peaking at 3.6 in the 45-49-year-old group. Older and male patients with all types of meningiomas, Black patients with benign and borderline meningiomas, and patients with larger borderline and malignant meningiomas showed poorer prognosis. For all meningioma types, surgical resection improved survival. The reported incidence rates and survival trends covered all demographics and subtypes of meningiomas. Older age, male sex, Black race, and tumor size may be important prognostic factors for meningioma cases, and tumor resection can substantially improve survival among meningioma patients.

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Meningiomas in the elderly, the surgical benefit and a new scoring system

Abstract: The present results suggest that common experience-based considerations may be optimized and implemented into a simple scoring system that in turn may allow for outcome prediction and evidence-based decision making

Cited by 73 publications

References 10 publications

Clinical features and surgical management of intracranial meningiomas in the elderly

Clinical features and surgical management of intracranial meningiomas in the elderly

Prognostic Significance of Hyperglycemia in Patients with Brain Tumors: a Meta-Analysis

Incidence and survival of benign, borderline, and malignant meningioma patients in the United States from 2004 to 2018

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