Long term outcome and health related quality of life of elderly patients after meningioma surgery.

OBJECTIVE: The incidence of meningiomas increases with increasing age. Because the median age for the diagnosis is 65 years, the patients' general health condition, comorbidities, and procedural risks will influence the postoperative functional outcomes. The aim of our study was to assess the long-term impairments of health-related quality of life (HRQOL) after meningioma resection in different age groups of elderly patients. METHODS: We analyzed the HRQOL of 133 patients aged >54 years at surgery who had undergone surgical meningioma resection from 2004 to 2010. The median age was 67.3 +/- 7.4 years. The average interval between surgery and questionnaire completion was 3.8 +/- 2.5 years. Six different 5-year age groups were established. The patients completed the Medical Outcomes Study short-form 36-item questionnaire, and the results were compared with general population values. The Kruskal-Wallis test and Mann-Whitney U test were used for statistical analysis. RESULTS: We found significantly lower levels of physical function, vitality, social role functioning, mental health, and general health perception and significantly greater levels of pain between the older age groups (in particular, 75-79 years) and younger patients aged 55-59 years. The physical component summary showed a steadily and stepwise decline from younger to older patients. However, the most significant differences in HRQOL were not related to age but to comorbidities. CONCLUSION: Our findings suggest that Karnofsky performance scale and American Society of Anesthesiologists scores have a strong effect on long-term HRQOL, especially for older patients after meningioma resection. These data should be a substantial consideration in the preoperative decision-making process.