Management of skull based meningiomas in the elderly patient

Röser, Florian; Ebner, Florian; Ritz, Rainer; Samii, M.; Tatagiba, Marcos; Nakamura, Makoto

doi:10.1016/j.jocn.2005.12.004

Cited by 52 publications

(30 citation statements)

References 20 publications

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“…Ten papers 3,6,26–33) included some patients with surgically removed meningioma as a part of all age or other treatments. The mean skull base-related location rate was 49.9%, and two studies focused only on skull base 29) or cerebellopontine angle lesions. 27) The mean tumor size rate over 4 cm was 79.5%, mean asymptomatic or no neurological deficit rate was 45.7%, and mean KPS score over 80 was 90%.…”

Section: Introductionmentioning

confidence: 99%

Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Ikawa

Kinoshita

Takeda

et al. 2017

Neurol. Med. Chir.(Tokyo)

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The Japanese population features the highest rate of elderly individuals worldwide. Moreover, Japan has the highest number of computed tomography/magnetic resonance imaging devices in the world, which has led to an increase in the incidental detection of meningioma in healthy elderly patients. Many previous papers have discussed the risks and indications for surgery in this patient population, but available information remains insufficient, and the definition of “elderly” has not been standardized. This review tried to clarify the published evidence and challenges associated with elderly meningioma based on a search of the PubMed database using the terms “meningioma,” “elderly,” and “surgery” for English-language clinical studies and collected related papers published from 2000 to 2016. Twenty-four papers were reviewed and classified by definition of elderly age: over 60, 65, 70, and 80 years old. Six of seven papers that defined the elderly cutoff as over 65 years old were published after 2010, which suggested the consensus definition. Four preoperative grading scoring systems were described and associated with mortality. The 1-year and 5-year mortality rates ranged from 0% to 16.7% and from 7% to 27%, which were comparable with unselected cohorts. Review of risk factor analysis emphasized the importance of considering the preoperative status, presence of comorbidities, and optimum surgical timing during patient selection. Careful choice of patients can also lead to better quality of life. A prospective randomized study considering patient frailty should address the causes and prevention of complications.

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Section: Introductionmentioning

confidence: 99%

Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Ikawa

Kinoshita

Takeda

et al. 2017

Neurol. Med. Chir.(Tokyo)

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“…With 38 papers [1–15, 17–22, 24–30, 32–41] in hand meeting our search criteria, we reviewed the assessment instruments utilized in each. While all of the papers included outcomes, when it came to QOL assessment, 2 of the 38 used SF36 [3, 19, 39] others used FACT-BR [5, 22, 40], and 8 used a more basic patient functionality-oriented Karnofsky Performance Status (KPS) comparison [10, 13, 28, 32, 34, 36, 37], and less than half (15 of 38 papers) utilized any QOL instrument at all (FACT-BR, SF36, KPS Scale, or some other instrument). None of the papers utilized site-specific questions.…”

Section: Methodsmentioning

confidence: 99%

FACT-MNG: tumor site specific web-based outcome instrument for meningioma patients

et al. 2010

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To formulate Functional Assessment of Cancer Therapy-Meningioma (FACT-MNG), a web-based tumor site-specific outcome instrument for assessing intracranial meningioma patients following surgical resection or stereotactic radiosurgery. We surveyed the relevant literature available on intracranial meningioma surgery and subsequent outcomes (38 papers), making note of which, if any, QOL/outcome instruments were utilized. None of the surgveyed papers included QOL assessment specific to tumor site. We subsequently developed questions that were relevant to the signs and symptoms that characterize each of 11 intracranial meningioma sites, and incorporated them into a modified combination of the Functional Assessment of Cancer Therapy-Brain (FACT-BR) and SF36 outcome instruments, thereby creating a new tumor site-specific outcome instrument, FACT-MNG. With outcomes analysis of surgical and radiosurgical treatments becoming more important, measures of the adequacy and success of treatment are needed. FACT-MNG represents a first effort to formalize such an instrument for meningioma patients. Questions specific to tumor site will allow surgeons to better assess specific quality of life issues not addressed in the past by more general questionnaires.

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“…For example, in one study of skull base meningiomas, only 3% of subjects had tumors in the anterior cranial fossa. 13 This is important because physical symptoms following skull base surgery depend on tumor location as well as surgical approach. 14 Some studies did not specify the surgical approach used, 13,15-17 assessed KPS only preoperatively 15 or postoperatively, 18 assessed KPS between subjects at variable time points following surgery, 16 or did not specify when the KPS assessment was undertaken.…”

Section: Karnofsky Performance Statusmentioning

confidence: 99%

“…12 In other studies, of skull base meningiomas in varying locations, KPS scores preoperatively and at last follow-up were lower but not significantly so. 13,16 Some studies have attempted to find variables associated with a worse KPS score. In a study of skull base meningiomas, female gender, higher histologic grade and p53-positive rate were associated with an unfavorable KPS, but radiation therapy, degree of resection, tumor size, tumor location, age of the patient, presence of calcification or a high T2weighted image were not.…”

Section: Karnofsky Performance Statusmentioning

confidence: 99%

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2014

J Neurol Surg B

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Management of skull based meningiomas in the elderly patient

Cited by 52 publications

References 20 publications

Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

FACT-MNG: tumor site specific web-based outcome instrument for meningioma patients

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