Meningioma in the elderly: Characteristics, prognostic factors, and surgical strategy

Meningioma is one of the most common intracranial tumors. It has the features of benign and slow growing. We focused on the meningioma in the elderly, retrospectively analyzed 528 valid meningioma patients, including 115 (21.8%) patients older than 65 years old. The elderly patients were shown to have significantly larger tumor diameter (mean [±SD] 43.4 ± 18.0 mm) comparing with the young group (mean [±SD] 37.6 ± 16.5 mm, p < 0.01). Post-operative KPS was significantly lower in the elderly group (mean [±SD] 79.64 ± 26.37) than the young group (mean [±SD] 88.81 ± 17.36, p < 0.01). Multivariate regression of post-operative KPS scales at discharge and 6 months follow-up showed operative complications, pre-operative comorbidities, tumor diameter, and challenging location had a significant impact on the outcome. However, tumor blood supply, Simpson grades, pathology, and pre-operative symptoms were shown to have less impact on the post-operative KPS scale. The outcome for meningioma in elderly patients was affected by factors related more to the safety of the operation than characteristics of the tumor. Therefore, rather than achieving total resection, conservative and safety preferential treatment strategies should be regarded as a higher priority for better quality of life.