SURGERY OF INTRACRANIAL MENINGIOMAS IN EL DERLY PATIENTS - PROGNOSIS FACTORS - 39 CASES

The aim of this study was to assess the current morbidity and mortalit y in patients over 70 operated for intracranial meningioma. Patients a nd method. - We report a series of 39 consecutive patients (mean age : 73 y) operated for an intracranial meningioma over a period of 5 year s (1990-1994). According to the Karnofski scale (KS), preoperative neu rological status was inferior or equal to 70 in 21 patients (53.8%) an d superior or equal to 80 in 18 (46.2%). All patients were followed up in order to precisely assess their postoperative condition and a comp uted tomographic scan (CT scan) was performed during the second semest er of 1995 (mean follow-up 29 months). Results. - Operative mortality and permanent morbidity were respectively 7.6% and 10.3%. In 77% of th is series, the KS score checked at the last follow up was 80 to 100 (g ood outcome). Poor outcome was defined by death or a postoperative (KS less than or equal to 70, the principal cause being an hemorrhagic in farction. Three factors were predictors of poor outcome: poor preopera tive neurological condition (KS less than or equal to 70) (p = 0.07), location of the tumor on the base (p = 0.007), and the duration of sur gery > 3 hours (p = 0.06). The logistical regression analysis showed t hat these three factors were independent. Tumor recurrence occurred in 5 (12.8%) of 39 patients. Conclusion. - Preoperative KS is a prognosi s factor, but a poor preoperative condition is not in itself a suffici ent condition contraindicating surgery. The rates of operative mortali ty of 7.6%, and permanent operative morbidity of 10.3% can be given to patients and their families.