Symptomatic peritumoral edema is associated with surgical outcome : a consecutive series of 72 supratentorial meningioma patients >= 80 years of age

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Schwartz , C , Rautalin , I , Niemela , M & Korja , M 2020 , ' Symptomatic peritumoral edema is associated with surgical outcome : a consecutive series of 72 supratentorial meningioma patients >= 80 years of age ' , Journal of Neuro-Oncology , vol. 148 , no. 1 , pp. 109-116 . https://doi.org/10.1007/s11060-020-03501-z

Title: Symptomatic peritumoral edema is associated with surgical outcome : a consecutive series of 72 supratentorial meningioma patients >= 80 years of age
Author: Schwartz, Christoph; Rautalin, Ilari; Niemela, Mika; Korja, Miikka
Contributor: University of Helsinki, Helsinki University Hospital Area
University of Helsinki, Neurokirurgian yksikkö
University of Helsinki, Department of Neurosciences
University of Helsinki, HUS Neurocenter
Date: 2020-05
Language: eng
Number of pages: 8
Belongs to series: Journal of Neuro-Oncology
ISSN: 0167-594X
URI: http://hdl.handle.net/10138/330371
Abstract: 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.
Subject: Edema volume
Elderly
Meningioma
Outcome
Resection
Tumor volume
INTRACRANIAL MENINGIOMAS
BRAIN EDEMA
9TH DECADE
SURGERY
LIFE
3122 Cancers
3112 Neurosciences
3124 Neurology and psychiatry
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