KEY TAKEAWAYS
- The study aimed to evaluate whether the mFI-5 and mFI-11 can predict postoperative outcomes in patients with meningioma aged over 80.
- The mFI-5 and mFI-11 predict mortality, complications, and functional benefit in patients with elderly meningioma, aiding outcome prediction.
Treating elderly patients with supratentorial meningiomas presents unique challenges due to age-related comorbidities and increased frailty. The Modified Frailty Index (mFI) is a tool used to assess frailty, and previous research suggests that higher mFI scores are linked to poorer surgical outcomes in patients with brain cancer.
Christoph Schwartz and his team aimed to determine whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices are linked to postoperative mortality, complications, and functional benefit in patients over 80 with supratentorial meningioma.
Researchers at 8 centers collected baseline data from patients. They assessed frailty preoperatively using the mFI-5 and mFI-11, based on patients’ preoperative status and comorbidities.
Scores were categorized as follows: Robust (mFI=0), Pre-frail (mFI=1), Frail (mFI=2), and Significantly Frail (mFI≥3). The Karnofsky Performance Scale (KPS) measured outcomes, with an improved KPS score indicating functional benefit. Researchers also evaluated patients’ functional independence, defined as a KPS score of 70 or higher, after surgery.
The study included 262 patients with a median age of 83 years and a median preoperative KPS of 70 (range 20 to 100). The 90-day mortality rate was 9.0%, and the 1-year mortality rate was 13.2%. Surgery-associated complications occurred in 111 patients (42.4%). At the last follow-up within the first postoperative year, 101 patients (38.5%) had an improved KPS, and 183 patients (69.8%) either gained or maintained functional independence.
“Severely frail” patients faced a higher risk of death at 90 days (OR 16.3 (CI95% 1.7-158.7)) and 1 year (OR 11.7 (CI95% 1.9-71.7)), with nine (42.9%) of these patients dying within the first year after surgery.
This cohort also had increased odds of surgery-associated complications (OR 3.9 (CI 95% 1.3-11.3)), but a higher likelihood of postoperative functional improvements with a KPS score increase of ≥20 (OR 6.6 (CI95% 1.2-36.2)).
The study demonstrated that the mFI-5 and mFI-11 effectively predict postoperative mortality, complication, and functional benefit likelihood in patients over 80 undergoing surgery for supratentorial meningiomas. Notably, “severely frail” patients, while facing higher risks, also exhibited a greater potential for functional improvement.
Open access funding provided by Paracelsus Medical University. None of the authors received any study-specific funding.
Source: https://link.springer.com/article/10.1007/s11060-024-04780-6
Schwartz C, Ueberschaer MF, Rautalin I, et al. (2024). “Frailty indices predict mortality, complications, and functional improvements in supratentorial meningioma patients over 80 years of age.” J Neurooncol. 2024. doi:10.1007/s11060-024-04780-6.
