Intracranial Meningiomas in Patients Aged ≥80 Years: Pathological Features and Surgical Problems.

Autor: Maiuri F; Department of Neuroscience, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples 'Federico II', Naples, Italy. Electronic address: frmaiuri@unina.it., Corvino S; Department of Neuroscience, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples 'Federico II', Naples, Italy., Lorenzetti M; Department of Neuroscience, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples 'Federico II', Naples, Italy., Franca RA; Department of Advanced Biomorphological Sciences, Section of Pathology, School of Medicine, University of Naples 'Federico II', Naples, Italy., Esposito F; Department of Neuroscience, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University of Naples 'Federico II', Naples, Italy., Del Basso De Caro M; Department of Advanced Biomorphological Sciences, Section of Pathology, School of Medicine, University of Naples 'Federico II', Naples, Italy.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2023 May; Vol. 173, pp. e498-e508. Date of Electronic Publication: 2023 Feb 24.
DOI: 10.1016/j.wneu.2023.02.086
Abstrakt: Background: Patients aged >80 years frequently have intracranial meningiomas. In the present study, we have discussed the pathological features, comorbidities, and surgical complications for this age group from a surgical series and literature review.
Methods: In the present study, we reviewed a surgical series of 354 intracranial meningiomas and compared the oldest age group (age, ≥80 years) of 17 patients with 73 patients aged 70-79 years and 264 patients aged <70 years. From a literature review, we selected 10 studies of meningiomas in patients aged ≥80 years. The analyzed factors included sex, meningioma location, World Health Organization grade, Ki-67 MIB1, progesterone receptor expression, comorbidities, American Society of Anesthesiologists class, Karnofsky performance scale score, postoperative complications, and death.
Results: Patients aged ≥80 years had had higher rates of World Health Organization grade II meningioma, higher rates of Ki-67 expression of >4% and <20%, and progesterone receptor expression <15%. Of the postoperative complications, only neurological deficits and acute bronchopneumonia were significantly more frequent in patients aged ≥80 years. The incidence of intracerebral hematoma, lung embolism, acute heart ischemia, and death were not significantly different between the patients aged ≥80 years and those aged 70-79 years and <70 years.
Conclusions: Patients aged ≥80 years must be considered a true elderly group with higher rates of comorbidities. The very old age is not a limitation to surgery; however, careful patient selection is necessary. In addition, for the oldest age group, the surgical decision should not be delayed because of advancing age.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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