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后颅窝脑膜瘤:70岁及以上与70岁以下患者的结果比较。

Posterior cranial fossa meningiomas: Comparison of results between patients older and younger than 70 years.

作者信息

Mastronardi Luciano, Campione Alberto, Alomari Amer Ahmad

机构信息

Department of Neurosurgery, San Filippo Neri Hospital/ASLRoma1, Rome, Italy.

出版信息

Brain Spine. 2024 Mar 26;4:102790. doi: 10.1016/j.bas.2024.102790. eCollection 2024.

Abstract

INTRODUCTION

Surgical strategy for meningioma resection in the elderly is controversial: diverse studies in the literature have pointed at the age as a negative prognostic factor in terms of postoperative results.

RESEARCH QUESTION

The aim of this study is to compare surgical outcomes after resection of posterior fossa meningiomas in <70 and ≥ 70 years-old age groups.

MATERIAL AND METHODS

We reviewed 72 patients affected by posterior fossa meningiomas who underwent surgical treatment at San Filippo Neri Hospital, Rome, Italy between September 2010 and December 2022. We analyzed data regarding tumor size, clinical presentation, extent of resection and complication/mortality.

RESULTS

The groups consisted of 52 (72,2%) young and 20 (27,8%) elderly patients. Gross total resection rate was significantly higher among youngsters (), mainly for planned subtotal removal in older patients. At 3-month follow-up, clinical improvement was seen in 19 (36,5%) young and 7 (35,0%) elderly patients, which raised at last follow-up, being 84,6% (44) and 80,0% (16), respectively (). Two cases of progression/recurrence among the elderly and 1 among youngsters were observed; one case of mortality among the elderly was reported.

DISCUSSION AND CONCLUSIONS

Safety data regarding postoperative complications and mortality in our series seem to confirm that there is no significant difference between older and younger patients, as long as older patients are carefully selected. Therefore, if surgery is proposed, it should be radical if gross total resection could be safely attempted.

摘要

引言

老年脑膜瘤切除的手术策略存在争议:文献中的各种研究指出,年龄是影响术后结果的负面预后因素。

研究问题

本研究的目的是比较年龄小于70岁和年龄大于等于70岁的后颅窝脑膜瘤切除术后的手术结果。

材料与方法

我们回顾了2010年9月至2022年12月期间在意大利罗马圣菲利普·内里医院接受手术治疗的72例后颅窝脑膜瘤患者。我们分析了有关肿瘤大小、临床表现、切除范围以及并发症/死亡率的数据。

结果

该组包括52名(72.2%)年轻患者和20名(27.8%)老年患者。年轻人的全切除率显著更高(),主要是因为老年患者计划行次全切除。在3个月的随访中,19名(36.5%)年轻患者和7名(35.0%)老年患者的临床症状有改善,在最后一次随访时有所增加,分别为84.6%(44例)和80.0%(16例)()。观察到老年患者中有2例病情进展/复发,年轻患者中有1例;报告了1例老年患者死亡。

讨论与结论

我们系列研究中关于术后并发症和死亡率的安全数据似乎证实,只要仔细挑选老年患者,老年患者和年轻患者之间没有显著差异。因此,如果建议进行手术,只要能安全尝试全切除,就应进行根治性手术。

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