Brain Tumor Res Treat.  2023 Apr;11(2):114-122. 10.14791/btrt.2023.0007.

Octogenarian Brain Tumor Registry: Single-Institution Surgical Outcomes and Mortality Study

• Phillips KR
• Filippidis A
• Mackel CE
• Enriquez-Marulanda A
• Vega RA

• KMID: 2542083
• DOI: http://doi.org/10.14791/btrt.2023.0007

Abstract

Background
Surgical intervention for brain tumor patients aged 80 to 89 years is controversial, as the comorbidities and physiology associated with aging are often thought to increase surgical risks. Surgical outcomes, however, are not well characterized for octogenarians. This review therefore assessed the outcomes and mortality risk associated with tumor removal in octogenarians at our academic institution.
Methods
Retrospective review of patients aged 80 to 89 who underwent craniotomy for tumor resection (CTR) at our institution between 2004–2021 and who were diagnosed with meningioma, glioblastoma, or metastatic disease. Primary outcome was 30-day mortality.
Results
Sixty-one CTRs were included in analysis. Median age was 83 (interquartile range 81–85) years, and the most common preoperative comorbidity was hypertension (n=44). Most patients (n=35) had a preoperative modified Rankin Scale (mRS) score between 0–2. Seventeen (27.9%) patients experienced postoperative complications (i.e., urinary tract infection, deep venous thrombosis, etc.), and 26.2% (n=16) experienced new-onset neurologic deficits postoperatively (i.e., aphasia, motor deficits, etc.). Upon discharge, most patients (n=43) had an mRS score of 3–4. Within 30 days of surgery, 14.8% (n=9) of patients were readmitted to the hospital and 8.2% (n=5) of patients died: 2 with meningioma, 1 with glioblastoma, and 2 with metastatic disease. The most common cause of death was intracranial hemorrhage (n=3). Three-month mortality was 23.0% (n=14). Mean survival after surgery was 33 months for meningioma patients, 6.9 months for glioblastoma patients, and 15 months for patients with metastatic lesions.
Conclusion
Our review found a 30-day mortality rate of 8.2% across all tumor types, and mean survival was similar to that previously reported for patients across all age groups. Surgical intervention for octogenarian tumor patients is therefore feasible, safe, and likely worthwhile for extending and improving lives.

Keyword

Brain neoplasms; Craniotomy; Mortality; Octogenarians

Figure

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  Fig. 1 Kaplan-Meier survival analysis curve for patients with meningioma, glioblastoma, or metastatic disease. Kaplan-Meier survival analysis was performed to evaluate overall longevity following surgery for octogenarian patients who underwent craniotomy for tumor resection. A total of 30 meningioma, 15 glioblastoma, and 16 metastatic lesion patients were analyzed. Mean survival was 33 months for the meningioma group, 6.9 months for the glioblastoma group, and 15 months postsurgery for the metastatic lesion group. Red dash lines indicate follow-up at 6, 12, 18, and 24 months. Log-rank test was significant with p<0.001.

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