Browsing by Subject "9TH DECADE"

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  • Rautalin, Ilari; Schwartz, Christoph; Niemelä, Mika; Korja, Miikka (2021)
    Population aging is likely increasing the number of surgically treated very old (>= 80-year-old) intracranial meningioma (IM) patients. Since there is little data on mortality in this patient group, we studied whether survival of surgically treated very old IM patients differs from survival of a matched general population. We retrospectively identified 83 consecutive very old IM patients (median age 83 years; 69% women) operated between 2010 and 2018. During the first postoperative year, operated IM patients suffered 2.5 times higher mortality as compared to age- and sex-matched general population but no annual survival difference occurred thereafter. Regarding cumulative estimates, no excess mortality was detected after the second postoperative year. Of the patient who were and who were not able to live at home preoperatively, 78% and 42% lived at home within 3 months, respectively. Preoperative loss of capability to live at home associated with a less frequent return to home [odds ratio (95% confidence interval) 0.21 (0.06-0.67)]. Operated very old IM patients had short-term excess mortality but similar cumulative survival as the matched general population. Moreover, most patients returned home soon after surgery.
  • Schwartz, Christoph; Rautalin, Ilari; Niemela, Mika; Korja, Miikka (2020)
    Purpose To assess the association of peritumoral brain edema (PTBE) with postoperative outcome in old (>= 80 years) meningioma patients. Methods All supratentorial meningioma patients (>= 80 years old) who underwent surgery between 2010 and 2018 were retrospectively identified. Patients were classified into poor (= 80) preoperative Karnofsky Performance Status (KPS) subgroups. Outcome was evaluated at 3 months and at last follow-up within the first year after surgery, and categorized as improved, stable, or deteriorated. Three-dimensional volumetric assessment of tumor and PTBE volume was conducted. Volumes were categorized as small (<10 cm(3)), medium (10-50 cm(3)), large (> 50 cm(3)). Results Seventy-two patients (mean age 83 +/- 3 years, median 83; median follow-up 3 years) were included. The mean tumor volume was 39 +/- 31 cm(3) (median 27), and mean PTBE volume was 57 +/- 79 cm(3) (median 27). The mean preoperative KPS and at last follow-up was 58 +/- 16 (median 60) and 59 +/- 30 (median 70). Thirty-three patients were classified as improved, 16 as stable, and 23 deteriorated; eleven patients died within the first year. Large PTBE volume was more common for patients with poor preoperative status (p = 0.001). However, patients with large PTBE and poor preoperative status improved most frequently following surgery (p = 0.037 at 3 months, p = 0.074 at last follow-up). Large PTBE volume was not associated with treatment-associated complications (p = 0.538) or mortality (p = 0.721). A decision support tool to predict outcome was developed (p = 0.038). Conclusion Elderly patients with large PTBE volumes usually had a poor preoperative performance status, but appeared to benefit most often from surgery.