Introduction: Meningiomas are the most common primary benign brain tumor. Radiosurgery (primary or adjuvant to partial resection) allows for excellent local control. The Geriatric scoring system (GSS) for pre-operative risk stratification and outcome prediction of patients with meningiomas has been previously reported. The GSS incorporates eight tumor and patient parameters on admission. A GSS score higher than 16 was found to be associated with a more favorable outcome. We assessed the validity of the GSS score and its influence on outcome in patients treated with gamma-knife radiosurgery (GKRS).

Methods: Patients treated with single session GKRS for WHO-1 meningioma during 1989-2013 at the University of Virginia were reviewed.

Results: A cohort of 323 patients, 50.2% (n=162) males. Median age 56 (29-84), median follow-up 53.6 (6-235) months. Median tumor volume 4.5 cm3 (0.2-23). Median margin and maximal doses 15 Gy (8-36) and 32.25 Gy (20-65) respectively. Tumor volume control was achieved in 87% (n=281), post-GKRS clinical improvement reported in 66.3% (n=214). Median change in KPS per-patient of +10 (-30 to +40) reported. The most common complication was headache (34.1%, n=110), followed by cranial nerve deficits (14.2%, n=46). The GSS (calculated and grouped as GSS>16 and GSS<=16) was found to significantly correlate with different outcome parameters (p=0.003 and p<0.0001 respectively).

Conclusions: The GSS scale, used for risk stratification and outcome prediction in patients with meningiomas seems valid for patients undergoing single session radiosurgery too. A GSS score greater than 16 is associated with a better long-term functional status, and tumor control.

Patient Care: Better outcome prediction can better assist in proper patient selection for benefit / risk ratio improvement.

Learning Objectives: The prognostic importance of the previously published GSS score in meningioma patients treated with stereotactic radiosurgery.

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