Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
| Autor: | Tunc Faik Ersoy, Florian Weissinger, Björn Berger, Philipp Schütt, Neda Mokhtari, Matthias Simon, Daniel Brainman, Attila Salay, Alexander Grote |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Chemotherapy complications business.industry medicine.medical_treatment Neoplasms. Tumors. Oncology. Including cancer and carcinogens prognostic factors cerebellar metastases medicine.disease survival Article Surgery Hydrocephalus Text mining Oncology Radiological weapon medicine neurosurgery Neurosurgery Major complication business Surgical treatment Complication RC254-282 |
| Zdroj: | Cancers Volume 13 Issue 21 Cancers, Vol 13, Iss 5263, p 5263 (2021) |
| ISSN: | 2072-6694 |
| DOI: | 10.3390/cancers13215263 |
| Popis: | We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Prognostic factors included clinical (but not radiological) hydrocephalus (medOS 11.3 vs. 5.2 months, p = 0.0374). Of note, a third of the patients with a KPI < 70% or multiple metastases survived > 12 months. Chemotherapy played a prominent prognostic role (medOS 15.5 vs. 2.3, p < 0.0001) possibly reflecting advances in treating systemic vis-à-vis controlled CNS disease. Major neurological (≥30 days), surgical and medical complications (CTCAE III–V) were observed in 8.2%, 13.7%, and 9.6%, respectively. The occurrence of a major complication markedly reduced survival (10.7 vs. 2.5 months, p = 0.020). The presence of extracerebral metastases did not significantly influence OS. Postponing staging was not associated with more complications or shorter survival. Together these data argue for individualized decision making which includes offering surgery in selected cases with a presumably adverse prognosis and also occasional urgent operations in cases without a preoperative oncological work-up. Complication avoidance is of utmost importance. |
| Databáze: | OpenAIRE |
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