• Giancarlo D'Andrea, Raffaelino Roperto, Emanuela Caroli, Francesco Crispo, and Luigi Ferrante.
• Department of Neurosurgery, University of Rome La Sapienza, II Faculty of Medicine, S. Andrea Hospital, Rome, Italy. gdandrea2002@yahoo.it
• Neurosurgery. 2005 May 1; 56 (5): 956-61; discussion 956-61.

ObjectiveWe report a series of 37 elderly patients who were surgically treated for intracranial meningioma in the ninth decade of life at our neurosurgical division between 1985 and 2002.MethodsOur study included 37 patients ranging in age from 80 to 86 years (29 women, 8 men). The preoperative neurological status was evaluated according to Karnofsky Performance Scale (KPS) status. The patients' general health condition was evaluated according to the American Society of Anesthesiology (ASA) classification.ResultsFive patients (13.5%) experienced perioperative mortality. The risk of postoperative mortality was higher in patients graded as ASA Class III who had low preoperative KPS ratings (< 70), whereas it was lower in patients graded as ASA Classes I and II (P > 0.001). The postoperative mortality rate was significantly higher in patients graded as having a KPS score of less than 70 (P > 0.01). The risk of postoperative morbidity seems higher with larger maximum tumor diameters (P < 0.05). Surgical excision and the presence of a severe peritumoral edema seem to be associated with a higher risk of postoperative morbidity (P < 0.05).ConclusionSurgical removal of a meningioma in the elderly is a safe procedure if the preoperative ASA classification is I or II and if the KPS rating is at least 70. Age seems not to be an insuperable obstacle when adequate management of all risk factors has been obtained.

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