Outcome of Cerebral Metastasectomy in Select Cases of Brain Metastases from Breast Cancer in Ibadan, Nigeria.

Autor: Ayandipo OO; Division of Oncological Surgery, Department of Surgery, College of Medicine, University of Ibadan/University College Hospital Ibadan, Ibadan, Nigeria., Adeleye AO; Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan/University College Hospital Ibadan, Ibadan, Nigeria. Electronic address: femdoy@yahoo.com., Ulasi IB; Department of Surgery, University College Hospital, Ibadan, Nigeria., Ogundiran TO; Division of Oncological Surgery, Department of Surgery, College of Medicine, University of Ibadan/University College Hospital Ibadan, Ibadan, Nigeria.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2019 Jul; Vol. 127, pp. 186-193. Date of Electronic Publication: 2019 Apr 04.
DOI: 10.1016/j.wneu.2019.03.279
Abstrakt: Background: Brain metastasis (BM) from breast cancer is increasingly encountered clinically because of the continuing success in the oncological control of the primary disease. Data-driven reports on the surgical treatment of BM from breast cancer are sparse in sub-Saharan Africa.
Methods: This is a prospective cohort study of the outcome of surgical excision of BM from breast cancer in an academic surgical practice in Ibadan, Nigeria.
Results: A total of 12 consecutive cerebral metastasectomies, all in females with primary breast cancer, were recorded over the study period. The median age (range) at breast cancer diagnosis was 41 (27-72) years, and the time interval from primary disease to BM was 19 (12-29) months. The BM was the first site of systemic disease progression in all, and was heralded by headache, seizures, and hemiparesis in more than two-thirds of the patients. The brain lesions were multiple in a quarter: >4 cm large in 42% and were located supratentorial in >80%. They all achieved good recovery and in-hospital outcome after surgical lesionectomy-infra- and supratentorial craniotomies-but only two-thirds could access postsurgical adjuvant whole brain radiation therapy. Median survival after cerebral metastasectomy was 18 (11-55) months, and more than a quarter were alive for ≥3years. These survival statistics were significantly better than those of a contemporary cohort of our patients with breast cancer who also had BMs that were not surgically treated for various clinical and logistic limitations.
Conclusions: Surgical resection is feasible for BM from breast cancer even in low-resource clinical practice. It has a salutary effect on the patients' quality of life.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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