Introduction

While surgery is the primary treatment choice for intracranial meningiomas in young patients, surgery in elderly patients, especially those with pre-existing comorbidities, has been the subject of repeated discussion. This study investigated the postoperative risks and neurological benefits of meningioma surgery in elderly patients compared to young patients.

Methods

In total, 768 patients were included and divided into two main groups: group I (age: ≤ 64 years; 484 young patients) and group II (age: ≥ 65 years; 284 elderly patients). Group II was subdivided into: IIa (age: 65–69 years), IIb (age: 70–79 years); and IIc (age: ≥ 80 years).

Results

The total tumor resection rate was higher in the elderly cohort than in the young cohort (84.5 and 76.2%, respectively). 154 young patients (31.8%) and 132 elderly patients (46.5%) developed postoperative morbidities, with the three most common being bleeding (12.9%), cranial nerve disorder (10%) and CSF fistula (8.1%). Postoperative bleeding, palsy, speech disorder, pneumonia and renal insufficiency were dependent on age (r = 0.123, p = 0.001; r = 0.089, p = 0.014; r = 0.100, p = 0.006; r = 0.098, p = 0.007 and r = 0.084, p = 0.020) and presented more often in elderly patients. 6 young and 15 elderly patients died during the 17.4-year observation period. Most patients showed a significant improvement in postoperative KPS (p < 0.001), except those over 80 years old (p = 0.753). The KPS at the last follow-up was significantly improved in all patients (p < 0.001).

Conclusion

Meningioma surgery is associated with a higher rate of postoperative complications in elderly patients than in young patients. Most elderly patients, similar to young patients, show a significant improvement in neurological status postoperatively.

中文翻译：

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与年轻患者相比，老年患者脑膜瘤手术的风险和神经系统益处

介绍

虽然手术是年轻患者颅内脑膜瘤的主要治疗选择，但老年患者的手术，特别是那些有合并症的患者，一直是反复讨论的主题。本研究调查了与年轻患者相比，老年患者脑膜瘤手术的术后风险和神经系统益处。

方法

总共包括 768 名患者，并分为两组：第一组（年龄：≤ 64 岁；484 名年轻患者）和第二组（年龄：≥ 65 岁；284 名老年患者）。II 组细分为：IIa（年龄：65-69 岁）、IIb（年龄：70-79 岁）；和 IIc（年龄：≥ 80 岁）。

结果

老年队列的总肿瘤切除率高于年轻队列（分别为 84.5% 和 76.2%）。154 名年轻患者 (31.8%) 和 132 名老年患者 (46.5%) 出现了术后并发症，其中三种最常见的是出血 (12.9%)、颅神经疾病 (10%) 和脑脊液瘘 (8.1%)。术后出血、麻痹、语言障碍、肺炎和肾功能不全取决于年龄（r = 0.123，p = 0.001；r = 0.089，p = 0.014；r = 0.100，p = 0.006；r = 0.098，p = 0.007 和 r = 0.084, p = 0.020)，并且在老年患者中更常见。在 17.4 年的观察期内，6 名年轻患者和 15 名老年患者死亡。大多数患者术后 KPS 有显着改善（p < 0.001），80 岁以上除外（p = 0.753）。

结论

与年轻患者相比，脑膜瘤手术与老年患者术后并发症的发生率较高有关。大多数老年患者，与年轻患者相似，术后神经功能状态有显着改善。