The role of scoring systems in treatment indication of meningiomas in elderly patients

Czech version

Authors: I. Rošková; A. Mrlian; M. Smrčka; M. Duba; V. Juráň
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno
Published in: Cesk Slov Neurol N 2022; 85(6): 471-476
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2022471

Overview

Introduction: The incidence of meningiomas increases exponentially after the age of 65. However, this age is characterized by a higher incidence of comorbidities and the benefit of the surgery may not always exceed its risk. Treatment optimization should therefore be objectively assessed using scoring systems as well. Materials and methods: A retrospective analysis evaluated the group of patients treated at the Brno University Hospital between 2013–2018 (N = 108). Patients were older than 65 years of age. Three procedures were considered in the treatment: watch and wait strategy, surgery and stereotactic radiosurgery. The groups of patients were evaluated in terms of the incidence of comorbidities and the outcome of the patients with regard to the choice of treatment modality. Scoring systems were used in the indication for individual types of treatment. Furthermore, short-term and long-term morbidity and mortality were evaluated in individual groups. Results: Significant dependence in the analysis of annual mortality in the SKALE system has been proved. No statistically significant relationship was found between mortality and sex, collateral oedema, and tumour location. In contrast, age, tumour size, and Karnofsky score before treatment were significant predictors of prognosis. Conclusion: Individualized patient analysis and neurosurgeon experience continue to be important factors in treatment selection in elderly patients with a diagnosis of meningioma. However, the scoring systems used to select a treatment modality in elderly patients make it possible to significantly optimize the treatment process and, ultimately, the prognosis of the disease.

Keywords:

geriatric patient – Meningioma – scoring systems

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