Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Fusao Ikawa; Yasuyuki Kinoshita; Masaaki Takeda; Taiichi Saito; Satoshi Yamaguchi; Fumiyuki Yamasaki; Koji Iida; Kazuhiko Sugiyama; Kazunori Arita; Kaoru Kurisu

doi:10.2176/nmc.ra.2017-0011

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Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Journal article

Open access

Peer reviewed

Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma

Fusao Ikawa, Yasuyuki Kinoshita, Masaaki Takeda, Taiichi Saito, Satoshi Yamaguchi, Fumiyuki Yamasaki, Koji Iida, Kazuhiko Sugiyama, Kazunori Arita and Kaoru Kurisu

Neurologia medico-chirurgica, Vol.57(10), pp.521-533

10/15/2017

DOI: 10.2176/nmc.ra.2017-0011

PMCID: PMC5638779

PMID: 28819091

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Abstract

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.

Age Factors

Aged

Aged, 80 and over

Cohort Studies

Comorbidity

Disease Progression

Frail Elderly

Hospital Mortality

Humans

Incidental Findings

Japan - epidemiology

Meningeal Neoplasms - epidemiology

Meningeal Neoplasms - pathology

Meningeal Neoplasms - surgery

Meningioma - epidemiology

Meningioma - pathology

Meningioma - surgery

Middle Aged

Neuroimaging - utilization

Neurosurgical Procedures

Patient Selection

Population Dynamics

Prognosis

Quality of Life

Risk Factors

Severity of Illness Index

Details

Title: Subtitle: Review of Current Evidence Regarding Surgery in Elderly Patients with Meningioma
Creators: Fusao Ikawa - Hiroshima University
Yasuyuki Kinoshita - Hiroshima University
Masaaki Takeda - Hiroshima University
Taiichi Saito - Hiroshima University
Satoshi Yamaguchi - Hiroshima University
Fumiyuki Yamasaki - Hiroshima University
Koji Iida - Hiroshima University
Kazuhiko Sugiyama - Hiroshima University Hospital
Kazunori Arita - Kagoshima University
Kaoru Kurisu - Hiroshima University
Resource Type: Journal article
Publication Details: Neurologia medico-chirurgica, Vol.57(10), pp.521-533
DOI: 10.2176/nmc.ra.2017-0011
PMID: 28819091
PMCID: PMC5638779
NLM abbreviation: Neurol Med Chir (Tokyo)
ISSN: 0470-8105
eISSN: 1349-8029
Language: English
Date published: 10/15/2017
Academic Unit: Neurosurgery
Record Identifier: 9984303895402771

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