Surgical resection of symptomatic brain metastases improves the clinical status and facilitates further treatment

Autor: Hans Christian Reinhardt, Maike Wittersheim, Roland Goldbrunner, Stephanie T Jünger, Stefan Grau, Petra Schödel, Nils-Ole Schmidt, Martin Proescholdt
Rok vydání: 2020
Předmět:
Adult
Male
0301 basic medicine
Surgical resection
Cancer Research
medicine.medical_specialty
Systemic disease
medicine.medical_treatment
Karnofsky performance score
Context (language use)
Kaplan-Meier Estimate
lcsh:RC254-282
Resection
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine
Adjuvant therapy
Humans
Radiology
Nuclear Medicine and imaging
Original Research
Aged
Proportional Hazards Models
Aged
80 and over
Brain Neoplasms
Proportional hazards model
business.industry
Clinical Cancer Research
Disease Management
Middle Aged
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Combined Modality Therapy
Tumor Burden
Surgery
Treatment Outcome
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Retreatment
Female
business
Adjuvant
Zdroj: Cancer Medicine, Vol 9, Iss 20, Pp 7503-7510 (2020)
Cancer Medicine
ISSN: 2045-7634
DOI: 10.1002/cam4.3402
Popis: Background Brain metastases (BM) frequently cause focal neurological deficits leading to a reduced Karnofsky performance score (KPS). Since KPS is routinely used to guide the choice of adjuvant therapy, we hypothesized that improving KPS by surgical resection may improve the chance for adjuvant treatment and ultimately result in better survival. We therefore analyzed the course of a large cohort undergoing resection of symptomatic brain metastases in the context of further treatment and clinical outcome. Patients and methods In a bi‐centric retrospective analysis we retrieved baseline, clinical, and treatment‐related parameters of patients operated on BM between 2010 and 2019. Survival was calculated using Kaplan‐Meier estimates; prognostic factors for survival were analyzed by Log‐rank test and Cox proportional hazards. Results We included 750 patients with a median age of 61 (19‐87) years. The functional status was significantly improved by surgical resection, with a median preoperative (KPS) of 80 (10‐100) increasing to 90 (0‐100) after surgery (P
In patients with symptomatic brain metastases systemic oncological treatment is the strongest factor for further survival. Resection of a symptomatic brain metastasis results in an improved clinical status which facilitates further treatment.
Databáze: OpenAIRE
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