TY - JOUR
T1 - Surgery for intracranial meningiomas in the elderly
T2 - A clinical- radiological grading system as a predictor of outcome
AU - Caroli, Manuela
AU - Locatelli, Marco
AU - Prada, Francesco
AU - Beretta, Federica
AU - Martinelli-Boneschi, Filippo
AU - Campanella, Rolando
AU - Arienta, Cesare
PY - 2005/2
Y1 - 2005/2
N2 - Object. A grading system, called the Clinical-Radiological Grading System (CRGS), has been developed to standardize surgical indications in elderly patients harboring intracranial meningiomas. Patients with a score lower than 10 had a bad prognosis regardless of surgical treatment, those with a score between 10 and 12 had a prognosis positively influenced by surgery, and those with a score higher than 12 had a good prognosis regardless of surgical treatment. The authors performed a prospective cross-sectional study to validate further the use of the CRGS as a clinical tool to orientate surgical decision making in elderly patients and to explore prognostic factors of survival. Methods. From 1990 to 2000 the authors consecutively recruited and surgically treated 90 patients 70 years of age or older with neuroimaging findings of intracranial meningiomas and a preoperative evaluation based on the CRGS. The surgical mortality rate, which covers deaths within 3 months after surgical intervention, was 7.8%, and the 1-year mortality rate was 15.6%. Female sex and a higher CRGS score were associated with a higher probability of survival. Among the different subset items of the CRGS score, no peritumoral edema for surgical survival and no concomitant diseases for 1-year survival provide the strongest predictive contribution, even if not at a statistically significant level. Conclusions. The CRGS score is a useful and practical tool for the selection of elderly patients affected by intracranial meningiomas as surgical candidates. A CRGS score higher than 10 and female sex are good prognostic factors of survival, whereas age is not a contraindication to surgery.
AB - Object. A grading system, called the Clinical-Radiological Grading System (CRGS), has been developed to standardize surgical indications in elderly patients harboring intracranial meningiomas. Patients with a score lower than 10 had a bad prognosis regardless of surgical treatment, those with a score between 10 and 12 had a prognosis positively influenced by surgery, and those with a score higher than 12 had a good prognosis regardless of surgical treatment. The authors performed a prospective cross-sectional study to validate further the use of the CRGS as a clinical tool to orientate surgical decision making in elderly patients and to explore prognostic factors of survival. Methods. From 1990 to 2000 the authors consecutively recruited and surgically treated 90 patients 70 years of age or older with neuroimaging findings of intracranial meningiomas and a preoperative evaluation based on the CRGS. The surgical mortality rate, which covers deaths within 3 months after surgical intervention, was 7.8%, and the 1-year mortality rate was 15.6%. Female sex and a higher CRGS score were associated with a higher probability of survival. Among the different subset items of the CRGS score, no peritumoral edema for surgical survival and no concomitant diseases for 1-year survival provide the strongest predictive contribution, even if not at a statistically significant level. Conclusions. The CRGS score is a useful and practical tool for the selection of elderly patients affected by intracranial meningiomas as surgical candidates. A CRGS score higher than 10 and female sex are good prognostic factors of survival, whereas age is not a contraindication to surgery.
KW - Clinical-radiological grading system
KW - Elderly
KW - Meningioma
UR - http://www.scopus.com/inward/record.url?scp=14844303998&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=14844303998&partnerID=8YFLogxK
U2 - 10.3171/jns.2005.102.2.0290
DO - 10.3171/jns.2005.102.2.0290
M3 - Article
C2 - 15739557
AN - SCOPUS:14844303998
VL - 102
SP - 290
EP - 294
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 2
ER -