The Geriatric Scoring System (GSS) in meningioma patients—validation
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Meningiomas are the most common primary brain tumor, the incidence of which rises with age. The Geriatric Scoring System (GSS) was constructed in an attempt to answer which elderly subpopulation will benefit from a surgical intervention in terms of their overall physical and functional state of health. The GSS incorporates different prognostic indicators, both clinical and radiological, for risk stratification.
The purpose of the study was to validate the previously defined GSS for the evaluation and risk stratification of elderly patients suffering from intracranial meningioma.
One hundred and twenty patients aged over 65 years admitted to the RAMBAM Medical Center with meningiomas during the years 2005–2010 were characterized, forming an independent cohort. We report the presenting symptoms, chronic illness and radiological features, as well as perioperative and long-term follow-up results up to 5 years after the surgery.
Nine outcome parameters were tested against the GSS score on admission. Survival, Barthel Index, Karnofsky Performance Scale (KPS), consciousness expressed by the Glasgow Coma Scale (GCS)  score 5 years after surgery, recurrence within and beyond 12 months of surgery, the length of hospitalization both overall and in a neurosurgical intensive care unit. A GSS score higher than 16 was associated with a significantly more favorable outcome.
The present results suggest that common experience-based considerations may be optimized and implemented into a simple scoring system that in turn may allow for outcome prediction and evidence-based decision making.
KeywordsElderly Evidence based medicine GSS score Meningioma Prognosis
Conflicts of interest
- 1.CBTRUS (Central Brain Tumor Registry of the United States) Statistical Report (2009–2010). Primary (malignant and non-malignant) brain and CNS tumor age-specific incidence rates by major histology groupings, histology and age at diagnosis, CBTRUS 2002–2006. http://www.cbtrus.org
- 6.Cushing H (1922) The meningiomas (dural endotheliomas): their source and favoured sets of origin. Brain 45:282–306Google Scholar
- 7.Cushing H Eisenhardt H (1938) Meningiomas: their classification, regional behavior, life history and surgical end results. Charles C. Thomas, SpringfieldGoogle Scholar
- 10.Hadded GF, OA-MSIA (2009) Extrinsic tumors, meningiomas. In: Youmans JR (ed) Youmans neurological surgery. Saunders, PhiledelphiaGoogle Scholar
- 12.Hijiya N, Hudson MM, Lensing S, Zacher M, Onciu M, Behm FG, Razzouk BI, Ribeiro RC, Rubnitz JE, Sandlund JT, Rivera GK, Evans WE, Relling MV, Pui CH (2007) Cumulative incidence of secondary neoplasms as a first event after childhood acute lymphoblastic leukemia. JAMA 297:1207–1215PubMedCrossRefGoogle Scholar
- 16.Lee JH, Sade B (2009) The novel “CLASS” algorithmic scale for patient selection in meningioma surgery. In: Lee JH (ed) Meningiomas: diagnosis, treatment, and outcome. Springer, London, pp 217–223Google Scholar
- 25.Rengachary SS, Suskind DL (1991) Meningiomas in the elderly and asymptomatic meningiomas. In: Al-Mefty O (ed) Meningiomas. Raven Press, New-York, pp 153–159Google Scholar