Nishizaki T, Kamiryo T, Fujisawa H, Ohshita N, Ishihara H, Ito H, Aoki H
Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
Acta Neurochir (Wien). 1994;126(2-4):59-62. doi: 10.1007/BF01476411.
During the 5 years from 1987 to 1991, 89 elderly patients, aged 70 years and over, were admitted to departments of neurosurgery in Yamaguchi prefecture with meningioma. The clinical features and prognostic implications of meningioma in the elderly were assessed retrospectively. Seventy-eight (88%) of the 89 patients underwent surgery, which was a higher rate than has been previously reported. The length of clinical history was also shorter than in previous studies, and was partly due to the recent introduction of magnetic resonance imaging (MRI). The incidence of poor prognosis (severe disability, vegetative or dead) in the elderly and a younger group aged less than 70 years was 13% and 7%, respectively, but the difference was not statistically significant. In the surgically treated elderly group, age did not influence the patient's outcome. The factors affecting the outcome were pre-operative neurological deficit (p < 0.05), histological malignancy (p < 0.05), and multiple operations (p < 0.05). Twenty-seven of the elderly meningioma patients were in good physical condition with minimal neurological involvement. They underwent total removal of the tumour at the first operation, and the histological diagnosis was benign. Twenty-five of these 27 patients fell into the best outcome category. Therefore, age alone was not a factor preventing proper surgical treatment of meningioma in the elderly.
在1987年至1991年的5年期间，山口县有89名年龄在70岁及以上的老年患者因脑膜瘤入住神经外科。对老年脑膜瘤的临床特征及预后影响进行了回顾性评估。89例患者中有78例（88%）接受了手术，这一比例高于先前报道。临床病史的时长也比先前研究中的短，部分原因是最近引入了磁共振成像（MRI）。老年组和年龄小于70岁的较年轻组中预后不良（严重残疾、植物人状态或死亡）的发生率分别为13%和7%，但差异无统计学意义。在接受手术治疗的老年组中，年龄并未影响患者的预后。影响预后的因素包括术前神经功能缺损（p<0.05）、组织学恶性程度（p<0.05）和多次手术（p<0.05）。27例老年脑膜瘤患者身体状况良好，神经功能受累轻微。他们在首次手术时肿瘤被完全切除，组织学诊断为良性。这27例患者中有25例属于最佳预后类别。因此，仅年龄并非妨碍对老年脑膜瘤进行适当手术治疗的因素。
