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Surgical Resection of Brain Metastases—Impact on Neurological Outcome

Brain metastases (BM) develop in about 30% of all cancer patients. Surgery plays an important role in confirming neuropathological diagnosis, relieving mass effects and improving the neurological status. To select patients with the highest benefit from surgical resection, prognostic indices (RPA, GP...

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Autores principales: Schödel, Petra, Schebesch, Karl-Michael, Brawanski, Alexander, Proescholdt, Martin Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Molecular Diversity Preservation International (MDPI) 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676752/
https://www.ncbi.nlm.nih.gov/pubmed/23615466
http://dx.doi.org/10.3390/ijms14058708
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author Schödel, Petra
Schebesch, Karl-Michael
Brawanski, Alexander
Proescholdt, Martin Andreas
author_facet Schödel, Petra
Schebesch, Karl-Michael
Brawanski, Alexander
Proescholdt, Martin Andreas
author_sort Schödel, Petra
collection PubMed
description Brain metastases (BM) develop in about 30% of all cancer patients. Surgery plays an important role in confirming neuropathological diagnosis, relieving mass effects and improving the neurological status. To select patients with the highest benefit from surgical resection, prognostic indices (RPA, GPA) have been formulated which are solely focused on survival without considering neurological improvement. In this study we analyzed the impact of surgical resection on the neurological status in addition to overall survival in 206 BM patients. Surgical mortality and morbidity was 0.0% and 10.3% respectively. New neurologic deficits occurred in 6.3% of all patients. The median overall survival was 6.3 months. Poor RPA class and short time interval between diagnosis of cancer and the occurrence of BM were independent factors predictive for poor survival. Improvement of neurological performance was achieved in 56.8% of all patients, with the highest improvement rate seen in patients presenting with increased intracranial pressure and hemiparesis. Notably, the neurological benefits were independent from RPA class. In conclusion, surgical resection leads to significant neurological improvement despite poor RPA class and short overall survival. Considering the low mortality and morbidity rates, resection should be considered as a valid option to increase neurological function and quality of life for patients with BM.
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spelling pubmed-36767522013-07-02 Surgical Resection of Brain Metastases—Impact on Neurological Outcome Schödel, Petra Schebesch, Karl-Michael Brawanski, Alexander Proescholdt, Martin Andreas Int J Mol Sci Article Brain metastases (BM) develop in about 30% of all cancer patients. Surgery plays an important role in confirming neuropathological diagnosis, relieving mass effects and improving the neurological status. To select patients with the highest benefit from surgical resection, prognostic indices (RPA, GPA) have been formulated which are solely focused on survival without considering neurological improvement. In this study we analyzed the impact of surgical resection on the neurological status in addition to overall survival in 206 BM patients. Surgical mortality and morbidity was 0.0% and 10.3% respectively. New neurologic deficits occurred in 6.3% of all patients. The median overall survival was 6.3 months. Poor RPA class and short time interval between diagnosis of cancer and the occurrence of BM were independent factors predictive for poor survival. Improvement of neurological performance was achieved in 56.8% of all patients, with the highest improvement rate seen in patients presenting with increased intracranial pressure and hemiparesis. Notably, the neurological benefits were independent from RPA class. In conclusion, surgical resection leads to significant neurological improvement despite poor RPA class and short overall survival. Considering the low mortality and morbidity rates, resection should be considered as a valid option to increase neurological function and quality of life for patients with BM. Molecular Diversity Preservation International (MDPI) 2013-04-24 /pmc/articles/PMC3676752/ /pubmed/23615466 http://dx.doi.org/10.3390/ijms14058708 Text en © 2013 by the authors; licensee MDPI, Basel, Switzerland http://creativecommons.org/licenses/by/3.0 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Article
Schödel, Petra
Schebesch, Karl-Michael
Brawanski, Alexander
Proescholdt, Martin Andreas
Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title_full Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title_fullStr Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title_full_unstemmed Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title_short Surgical Resection of Brain Metastases—Impact on Neurological Outcome
title_sort surgical resection of brain metastases—impact on neurological outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676752/
https://www.ncbi.nlm.nih.gov/pubmed/23615466
http://dx.doi.org/10.3390/ijms14058708
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