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Open craniotomy for tumor carries notable perioperative risks as well as associated prolonged ICU stays. Risks of surgery are increased in elderly patients. In addition, many tumors are not amenable to resection due to their deep or eloquent location. Magnetic resonance-guided laser interstitial thermal ablation (LITT) offers an alternative, minimal-access procedure. OBJECTIVE To examine the safety and efficacy of LITT procedures in elderly brain tumor patients. METHODS Data was gathered on patients over the age of 65 who underwent MRI-guided LITT for ablation of tumor at our institution between 2014-2019. These cases were analyzed retrospectively and data was collected on patient demographics, tumor characteristics, procedural details, and post-operative complications and outcomes. RESULTS 19 patients over the age of 65 underwent LITT during the study time period and were included in the analysis. The average age was 70 years (range 65-81), with a median follow up of 7 months. Patients had an average of 3.5 pre-existing medical comorbidities with a mean pre-operative Karnofsky Performance Score (KPS) of 87 (SD = 10.4). 13 patients underwent LITT for primary CNS tumor and 6 for metastatic lesions. The average lesion volume was 3.44 cm3 with approximately one-third in eloquent areas. An average extent of ablation of 98% was achieved (90-100%). 5/19 patients experience at least one post-op complication including 2 venous thromboembolic events and 1 stroke within 30 days. The average length of stay was 2.3 days, and 13/19 patients were discharged home. No patients experienced new permanent neurological deficits and the average post-operative KPS was 83 (SD = 12.4). 9 patients experienced progression of disease after an average of 155 days, and 11 patients were deceased (average survival = 504 days). CONCLUSION LITT is well tolerated in appropriately selected elderly patients with short post-operative length of stay and minimal surgical morbidity.

SURG-17. EFFICACY AND SAFETY OF LASER INTERSTITIAL THERMAL ABLATION IN ELDERLY BRAIN TUMOR PATIENTS