Surgical outcome in elderly patients with intracranial meningioma

The aim of this study was to examine the utility of surgical management of intracranial meningioma in elderly patients. A total of 138 patients with intracranial meningiomas who underwent surgery from 2008 to 2017 were divided into elderly (≥75 years old, n = 34) and younger (<75 years old, n = 104) groups. Clinical and radiological data were retrospectively analyzed. Total tumor removal was achieved in 79% of elderly patients, which was similar to that in young patients (85%, p = .81). The average preoperative Karnofsky performance scale score in elderly patients was significantly lower than that in young patients (70.6 vs. 90.4, respectively; p < .0001). However, the average change in the Karnofsky performance scale score after surgery was similar between the two groups (0.3 vs. -0.4, respectively; p = .36). Histopathological grading revealed that the incidence of malignant meningioma (World Health Organization grades II and III) was significantly higher in elderly patients than that in young patients (44% vs. 14%, respectively; p = .004). Among meningiomas showing chronological progression, World Health Organization grade II and III meningiomas accounted for 67% of tumors in elderly patients, but only 23% in younger patients (p = .01). These data suggest that surgical removal of meningiomas may be a safe and useful treatment strategy in elderly patients.