Surgery for brain metastases: An analysis of outcomes and factors affecting survival.

Autor: Sivasanker M; Division of Neurosurgery, Neuro-oncology Disease Management Group, Tata Memorial Center (Tata Memorial Hospital and the Advanced Centre for Treatment, Research and Education in Cancer), Mumbai, 400012, India., Madhugiri VS; Division of Neurosurgery, Neuro-oncology Disease Management Group, Tata Memorial Center (Tata Memorial Hospital and the Advanced Centre for Treatment, Research and Education in Cancer), Mumbai, 400012, India.. Electronic address: venkatesh@cancerinstitute.in., Moiyadi AV; Division of Neurosurgery, Neuro-oncology Disease Management Group, Tata Memorial Center (Tata Memorial Hospital and the Advanced Centre for Treatment, Research and Education in Cancer), Mumbai, 400012, India., Shetty P; Division of Neurosurgery, Neuro-oncology Disease Management Group, Tata Memorial Center (Tata Memorial Hospital and the Advanced Centre for Treatment, Research and Education in Cancer), Mumbai, 400012, India., Subi TS; Division of Neurosurgery, Neuro-oncology Disease Management Group, Tata Memorial Center (Tata Memorial Hospital and the Advanced Centre for Treatment, Research and Education in Cancer), Mumbai, 400012, India.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2018 May; Vol. 168, pp. 153-162. Date of Electronic Publication: 2018 Mar 10.
DOI: 10.1016/j.clineuro.2018.03.011
Abstrakt: Objectives: For patients who develop brain metastases from solid tumors, age, KPS, primary tumor status and presence of extracranial metastases have been identified as prognostic factors. However, the factors that affect survival in patients who are deemed fit to undergo resection of brain metastases have not been clearly elucidated hitherto.
Patients and Methods: This is a retrospective analysis of a prospectively maintained database. All patients who underwent resection of intracranial metastases from solid tumors were included. Various patient, disease and treatment related factors were analyzed to assess their impact on survival.
Results: Overall, 124 patients had undergone surgery for brain metastases from various primary sites. The median age and pre-operative performance score were 53 years and 80 respectively. Synchronous metastases were resected in 17.7% of the patients. The postoperative morbidity and mortality rates were 17.7% and 2.4% respectively. Adjuvant whole brain radiation was received by 64 patients. At last follow-up, 8.1% of patients had fresh post-surgical neurologic deficits. The median progression free and overall survival were 6.91 was 8.56 months respectively.
Conclusions: Surgical resection of for brain metastases should be considered in carefully selected patients. Gross total resection and receiving adjuvant whole brain RT significantly improves survival in these patients.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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