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Postoperative Long-Term Independence Among the Elderly With Meningiomas: Function Evolution, Determinant

Haoyi Li1, Huawei Huang2, Xiaokang Zhang1

  • 1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Frontiers in Oncology
|March 25, 2021
PubMed
Summary

Postoperative independence in elderly meningioma patients significantly declines, with factors like advanced age and tumor recurrence increasing risk. This study identifies key determinants to guide surgical management and rehabilitation strategies for improved patient outcomes.

Keywords:
functional evolutionindependencemeningiomaprediction modelthe elderly

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Area of Science:

  • Neurosurgery
  • Geriatric Medicine
  • Oncology

Background:

  • Maintaining long-term independence is crucial for elderly surgical patients.
  • Independence decline in elderly meningioma patients is understudied.
  • Identifying factors influencing independence is vital for targeted interventions.

Purpose of the Study:

  • To assess the evolution of long-term postoperative independence in elderly meningioma patients.
  • To identify determinants of postoperative independence in this population.
  • To develop a predictive model for long-term independence.

Main Methods:

  • Retrospective study of 470 elderly meningioma patients (≥65 years) from 2010-2016.
  • Primary outcome: 3-year postoperative independence using Karnofsky Performance Scale (KPS).
  • Univariate/multivariate analyses and nomogram construction to identify risk factors.

Main Results:

  • Significant KPS decline observed 3 years post-surgery, with notable polarization in patients with preoperative KPS 80 and 70.
  • Common symptoms impacting independence included fatigue, memory impairment, motor dysfunction, and communication deficits.
  • Independent risk factors for non-independence: advanced age, recurrent meningioma, skull base location, large tumor size, nerve involvement, high WHO grade, recurrence during follow-up, lower preoperative KPS, and decreased KPS at discharge. Nomogram showed good predictive ability (C-index: 0.810).

Conclusions:

  • Elderly meningioma patients exhibit a significant trend towards decreased long-term independence post-surgery.
  • Findings aid in surgical decision-making and inform early functional rehabilitation strategies.
  • The developed nomogram offers a valuable tool for predicting long-term independence outcomes.