[Comparison of intracranial meningioma outcome scales in operated patients older than 65 years old. Our experience between 2002-2012 and a literature review]

Abstract

Objective: Meningioma is the most common intracranial tumor in the elderly. Its incidence rate increases with age; so as life expectancy increases, meningiomas are diagnosed more frequently. A comparison is made between 4 outcome scales in this study: Clinical-Radiological Grading System, Geriatric Scoring Scale, SKALE (Sex, Karnofsky, ASA, localization and edema), and the Charlson score, to analyze which patients could benefit from surgery.

Materials and methods: A total of 52 patients of 65 years and older operated in our hospital between 2002 and 2012 were identified, and a retrospective analysis was performed. All individual variables were collected and applied the scales to see their relationship with 3 month and annual mortality. The critical values of each scale were applied and their positive and negative predictive values were calculated.

Results: From the four scales, only the Clinical-Radiological Grading System and the SKALE had a significant statistical result when annual mortality was analyzed. None of them were associated with 3 month mortality. There was no statistically significant association between mortality and sex, edema, previous clinical history, and tumor location. But there was an association with age, tumor size and previous Karnofsky.

Conclusion: The SKALE and the Clinical-Radiological Grading System are easy tools that can give an insight as regards patients who can benefit from a surgical treatment. Nevertheless, individualized patient analysis and neurosurgeon experience still have great importance.

Keywords: Anciano; Cirugía y mortalidad; Elderly; Escala; Meningioma; Outcome; Pronóstico; Scale; Surgery and mortality.