Therapeutic Strategies of the Intracranial Meningioma in Elderly Patients. |
Young Jin Song, Soon Ki Sung, Seung Jin Noh, Hyung Dong Kim |
Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea. hdkim@donga.ac.kr |
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ABSTRACT |
OBJECTIVE The apparent increase in the incidence of the intracranial meningiomas in the elderly is due in part to improved diagnostic tools and improved span of life. The authors carried out a retrospective study to validate the use of the Clinical-Radiological Grading System (CRGS) as a clinical tool to orientate surgical decision making in elderly patients and to explore prognostic factors of survival. METHODS From January 1997 to January 2006, the authors consecutively recruited and surgically treated 20 patients older than 65 years of age with radiologic findings of intracranial meningiomas and a preoperative evaluation based on the CRGS. RESULTS High CRGS score was associated with a higher probability of good outcome (p=0.004) and a lower probability of postoperative complications (p=0.049). Among the different subset items of the CRGS score, larger maximum tumor diameters (D> or =4cm) and the presence of a severe peritumoral edema were associated with incidence rate of postoperative poor outcome and complications (p<0.05).
Additionally, the critical location of the tumor was also correlated with poor outcome (p<0.05). CONCLUSION A CRGS score higher than 13 is a good prognostic indication of survival. The CRGS score is a useful and practical tool for the selection of elderly patients affected by intracranial meningiomas as surgical candidates. |
Key Words:
Intracranial meningioma; CRGS; Elderly patients; Prognosis |
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