Brain tumor surgery in geriatric patients: A critical analysis in 44 patients over 80 years

BACKGROUND The decision of whether to operate on brain tumors in elderly pa tients has not been made easier despite diagnostic and therapeutic advances facilitating their diagnosis, Little is known about the outcome of brain t umor surgery in patients 80 years or older probably because the number of t hese patients, although increasing, is still small. METHODS The results of brain tumor surgery in 44 patients aged 80-86 years (mean age 83 years) were analyzed to determine which factors are relevant i n the evaluation of the operative risk. The following parameters were analy zed with regard to the outcome: tumor volume, location, histopathology, pre operative condition, and concomitant diseases. RESULTS At discharge 19 patients (43%) had improved while 14 (32%) remained unchanged. Nevertheless, the overall results were unsatisfactory in 10 pat ients (23%), of whom 5 died in hospital. Tumor location, volume, and histop athology did not correlate with the outcome. The preoperative cerebrovascul ar condition and the existence of multiple concomitant diseases were clearl y the determining factors for the outcome. CONCLUSIONS These results indicate that patients with life-threatening tumo rs or those causing persistent and intolerable brain dysfunction suffering from symptomatic cerebrovascular atherosclerosis as well as from multiple t reatment requiring concomitant diseases did definitely not benefit from sur gery. (C) 1999 by Elsevier Science Inc.