The Geriatric Scoring System (GSS) for Risk Stratification in Meningioma Patients as a Predictor of Outcome in Patients Treated with Radiosurgery.

INTRODUCTION

Meningiomas are the most common primary benign brain tumor. Radiosurgery (primary or adjuvant) allows excellent local control. The Geriatric Scoring System (GSS) for preoperative risk stratification and outcome prediction of patients with meningiomas has been reported previously. The GSS incorporates 8 tumor and patient parameters on admission. A GSS score greater than 16 was reported previously to be associated with a more favorable outcome. We assessed the validity of the GSS score and its influence on outcome in patients treated with Gamma-Knife radiosurgery (GKRS).

PATIENTS AND METHODS

Patients treated with single-session GKRS for World Health Organization grade I meningioma during 1989-2013 at the University of Virginia were reviewed. The cohort comprised 323 patients, 50.2% (n = 162) male. Median age was 56 years (29-84 years), and median follow-up was 53.6 months (6-235 months). Median tumor volume was 4.5 cm(3) (0.2-23). Median margin and maximal doses were 15 Gy (8-36) and 32.3 Gy (20-65), respectively.

RESULTS

Tumor volume control was achieved in 87% (n = 281), and post-GKRS clinical neurologic improvement was reported in 66.3% (n = 214). The median change in KPS was +10 (range -30 to +40). The most common complication was intermittent headaches (34.1%, n = 110) and cranial nerve deficits (14.2%, n = 46). The GSS (calculated and grouped as GSS > 16 and GSS ≤ 16) was found to correlate with different post-GKRS functional status (P < 0.0001) and tumor control (P = 0.028).

CONCLUSION

The GSS, used for risk stratification and outcome prediction in patients with meningiomas, seems valid for patients undergoing single-session GRKS. A GSS score greater than 16 is associated with a better long-term functional status and tumor control.