TY  - JOUR
A1  - Monden, Daniel
A1  - Raimann, Florian
A1  - Neef, Vanessa
A1  - Dubinski, Daniel
A1  - Geßler, Florian
A1  - Keil, Fee
A1  - Forster, Marie-Thérèse
A1  - Ronellenfitsch, Michael Wilfried
A1  - Harter, Patrick Nikolaus
A1  - Freiman, Thomas Michael
A1  - Hattingen, Elke
A1  - Seifert, Volker
A1  - Senft, Christian
A1  - Baumgarten, Peter
T1  - Meningioma surgery in patients ≥70 years of age: clinical outcome and validation of the SKALE score
T2  - Journal of Clinical Medicine
N2  - Along with increasing average life expectancy, the number of elderly meningioma patients has grown proportionally. Our aim was to evaluate whether these specific patients benefit from surgery and to investigate a previously published score for decision-making in meningioma patients (SKALE). Of 421 patients who underwent primary intracranial meningioma resection between 2009 and 2015, 71 patients were ≥70 years of age. We compared clinical data including World Health Organization (WHO) grade, MIB-1 proliferation index, Karnofsky Performance Status Scale (KPS), progression free survival (PFS) and mortality rate between elderly and all other meningioma patients. Preoperative SKALE scores (Sex, KPS, ASA score, location and edema) were determined for elderly patients. SKALE ≥8 was set for dichotomization to determine any association with outcome parameters. In 71 elderly patients (male/female 37/34) all data were available. Postoperative KPS was significantly lower in elderly patients (p < 0.0001). Pulmonary complications including pneumonia (10% vs. 3.2%; p = 0.0202) and pulmonary embolism (12.7% vs. 6%; p = 0.0209) occurred more frequently in our elderly cohort. Analyses of the Kaplan Meier curves revealed differences in three-month (5.6% vs. 0.3%; p = 0.0033), six-month (7% vs. 0.3%; p = 0.0006) and one-year mortality (8.5% vs. 0.3%; p < 0.0001) for elderly patients. Statistical analysis showed significant survival benefit in terms of one-year mortality for elderly patients with SKALE scores ≥8 (5.1 vs. 25%; p = 0.0479). According to our data, elderly meningioma patients face higher postoperative morbidity and mortality than younger patients. However, resection is reasonable for selected patients, particularly when reaching a SKALE score ≥ 8.
KW  - meningioma
KW  - elderly
KW  - KPS
KW  - SKALE score
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/61187
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-611876
SN  - 2077-0383
VL  - 10
IS  - 9, art. 1820
SP  - 1
EP  - 12
PB  - MDPI
CY  - Basel
ER  -