Details

Autor(en) / Beteiligte

• Sivasanker, Masillamany
• Madhugiri, Venkatesh S
• Moiyadi, Aliasgar V
• Shetty, Prakash
• Subi, T S

Titel

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

Ist Teil von

• Clinical neurology and neurosurgery, 2018-05, Vol.168, p.153-162

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• •Resectability of the lesion should be the primary concern for patients with brain metastases.•The site of the primary cancer does not affect outcome.•Age <60 and neurologically intact status are associated with longer survival.•Gross total resection and adjuvant radiotherapy are the most important factors affecting survival. 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. 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. 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. 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.