Microsurgical resection of intracranial meningiomas in patients aged 80 years old or more: A systematic review and meta-analysis

被引:0
作者
Diaz, Simon [1 ]
Levivier, Marc [1 ,2 ]
Reyns, Nicolas [3 ]
Tuleasca, Constantin [1 ,2 ,4 ]
机构
[1] Lausanne Univ Hosp CHUV, Neurosurg Serv & Gamma Knife Ctr, Lausanne, Switzerland
[2] Univ Lausanne UNIL, Fac Biol & Med FBM, Lausanne, Switzerland
[3] Roger Salengro Hosp, Ctr Hosp Reg Univ Lille, Neurosurg & Neurooncol Serv, Lille, France
[4] Ecole Polytech Fed Lausanne EPFL, LTS 5, Lausanne, Switzerland
来源
BRAIN AND SPINE | 2025年 / 5卷
关键词
Intracranial meningioma; Microsurgical resection; Mortality; Morbidity; Elderly; ELDERLY-PATIENTS; 9TH DECADE; SURGERY; EXPERIENCE; LIFE;
D O I
10.1016/j.bas.2025.104201
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: The incidence of intracranial meningiomas rises with advancing age, raising the question of whether similar surgical outcomes in morbidity and mortality can be expected compared to younger population. We conducted a systematic review and meta-analysis of research examining microsurgical outcomes in those aged 80 years or older. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed articles published between January 1995 and January 2024, referenced in PubMed or Embase. Inclusion criteria were peer-reviewed clinical studies of series reporting microsurgical resection of intracranial meningiomas in patients aged 80 years or more, written in English. Primary outcome was EOR (extend of resection), classified as tumor total resection versus partial resection. Secondary outcomes were morbidity and mortality. Results: Ten studies reported 690 patients. Total tumor resection was achieved in 88% of cases (range 85-91; I-2 = 56; p heterogeneity = 0.02; p < 0.01). Tumor partial resection was achieved in 12% (range 9-15; I<^>2 = 56; p heterogeneity = 0.02 and p < 0.001). Postsurgical intracerebral hemorrhage was encountered in 1% of cases (range 0-2; I<^>2 = 69; p heterogeneity = < 0.01). Surgical mortality was encountered in 5% of cases (range 3-7; I<^>2 = 61; p heterogeneity = < 0.01). Conclusion: Current data suggests that achieving high total resection rates, up to 88%, is feasible. The surgical mortality rate was 5%. A key unresolved neurosurgical dilemma is whether to operate on patients over 80 years old. Future studies are essential to assess all relevant risk factors comprehensively.
引用
收藏
页数:7
相关论文
共 21 条
  • [1] Awad I.A., Kalfas I., Hahn J.F., Little J.R., Intracranial meningiomas in the aged: surgical outcome in the era of computed tomography, Neurosurgery, 24, 4, pp. 557-560, (1989)
  • [2] Caroli M., Locatelli M., Prada F., Et al., Surgery for intracranial meningiomas in the elderly: a clinical-radiological grading system as a predictor of outcome, J. Neurosurg., 102, 2, pp. 290-294, (2005)
  • [3] Cornu P., Chatellier G., Dagreou F., Et al., Intracranial meningiomas in elderly patients. Postoperative morbidity and mortality. Factors predictive of outcome, Acta Neurochir (Wien), 102, 3-4, pp. 98-102, (1990)
  • [4] D'Andrea G., Roperto R., Caroli E., Crispo F., Ferrante L., Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature, Neurosurgery, 56, 5, pp. 956-961, (2005)
  • [5] Dobran M., Marini A., Nasi D., Et al., Surgical treatment and outcome in patients over 80 years old with intracranial meningioma, Clin. Neurol. Neurosurg., 167, pp. 173-176, (2018)
  • [6] Joubert C., Sellier A., Sahuc P., Et al., Neurosurgery for intracranial meningioma in patients aged more than 80 years: benefits and rationale, Br. J. Neurosurg., 35, 4, pp. 470-475, (2021)
  • [7] Konglund A., Rogne S.G., Helseth E., Meling T.R., Meningioma surgery in the very old-validating prognostic scoring systems, Acta Neurochir (Wien), 155, 12, pp. 2263-2271, (2013)
  • [8] Mastronardi L., Ferrante L., Qasho R., Ferrari V., Tatarelli R., Fortuna A., Intracranial meningiomas in the 9th decade of life: a retrospective study of 17 surgical cases, Neurosurgery, 36, 2, pp. 270-274, (1995)
  • [9] McGrail K.M., Ojemann R.G., The surgical management of benign intracranial meningiomas and acoustic neuromas in patients 70 years of age and older, Surg. Neurol., 42, 1, pp. 2-7, (1994)
  • [10] Moher D., Liberati A., Tetzlaff J., Altman D.G., Group P., Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, J. Clin. Epidemiol., 62, 10, pp. 1006-1012, (2009)