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Survival outcomes following craniotomy for intracranial metastases from an unknown primary
INTRODUCTION: Management of patients with intracranial metastases from an unknown primary tumor (CUP) varies compared to those with metastases of known primary tumor origin (CKP). The National Institute for Health and Care Excellence (NICE) recognizes the current lack of research to support the mana...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392948/ https://www.ncbi.nlm.nih.gov/pubmed/32358736 http://dx.doi.org/10.1007/s10147-020-01687-w |
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author | Gough, Melissa Nielsen, Molly Coulter, Ian C. Holliman, Damian |
author_facet | Gough, Melissa Nielsen, Molly Coulter, Ian C. Holliman, Damian |
author_sort | Gough, Melissa |
collection | PubMed |
description | INTRODUCTION: Management of patients with intracranial metastases from an unknown primary tumor (CUP) varies compared to those with metastases of known primary tumor origin (CKP). The National Institute for Health and Care Excellence (NICE) recognizes the current lack of research to support the management of CUP patients with brain metastases. The primary aim was to compare survival outcomes of CKP and CUP patients undergoing early resection of intracranial metastases to understand the efficacy of surgery for patients with CUP. METHODS: A retrospective study was performed, wherein patients were identified using a pathology database. Data was collected from patient notes and trust information services. Surgically managed patients during a 10-year period aged over 18 years, with a histological diagnosis of intracranial metastasis, were included. RESULTS: 298 patients were identified, including 243 (82.0%) CKP patients and 55 (18.0%) CUP patients. Median survival for CKP patients was 9 months (95%CI 7.475–10.525); and 6 months for CUP patients (95%CI 4.263–7.737, p = 0.113). Cox regression analyses suggest absence of other metastases (p = 0.016), age (p = 0.005), and performance status (p = 0.001) were positive prognostic factors for improved survival in cases of CUP. The eventual determination of the primary malignancy did not affect overall survival for CUP patients. CONCLUSIONS: There was no significant difference in overall survival between the two groups. Surgical management of patients with CUP brain metastases is an appropriate treatment option. Current diagnostic pathways specifying a thorough search for the primary tumor pre-operatively may not improve patient outcomes. |
format | Online Article Text |
id | pubmed-7392948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-73929482020-08-12 Survival outcomes following craniotomy for intracranial metastases from an unknown primary Gough, Melissa Nielsen, Molly Coulter, Ian C. Holliman, Damian Int J Clin Oncol Original Article INTRODUCTION: Management of patients with intracranial metastases from an unknown primary tumor (CUP) varies compared to those with metastases of known primary tumor origin (CKP). The National Institute for Health and Care Excellence (NICE) recognizes the current lack of research to support the management of CUP patients with brain metastases. The primary aim was to compare survival outcomes of CKP and CUP patients undergoing early resection of intracranial metastases to understand the efficacy of surgery for patients with CUP. METHODS: A retrospective study was performed, wherein patients were identified using a pathology database. Data was collected from patient notes and trust information services. Surgically managed patients during a 10-year period aged over 18 years, with a histological diagnosis of intracranial metastasis, were included. RESULTS: 298 patients were identified, including 243 (82.0%) CKP patients and 55 (18.0%) CUP patients. Median survival for CKP patients was 9 months (95%CI 7.475–10.525); and 6 months for CUP patients (95%CI 4.263–7.737, p = 0.113). Cox regression analyses suggest absence of other metastases (p = 0.016), age (p = 0.005), and performance status (p = 0.001) were positive prognostic factors for improved survival in cases of CUP. The eventual determination of the primary malignancy did not affect overall survival for CUP patients. CONCLUSIONS: There was no significant difference in overall survival between the two groups. Surgical management of patients with CUP brain metastases is an appropriate treatment option. Current diagnostic pathways specifying a thorough search for the primary tumor pre-operatively may not improve patient outcomes. Springer Singapore 2020-05-01 2020 /pmc/articles/PMC7392948/ /pubmed/32358736 http://dx.doi.org/10.1007/s10147-020-01687-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Gough, Melissa Nielsen, Molly Coulter, Ian C. Holliman, Damian Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title | Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title_full | Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title_fullStr | Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title_full_unstemmed | Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title_short | Survival outcomes following craniotomy for intracranial metastases from an unknown primary |
title_sort | survival outcomes following craniotomy for intracranial metastases from an unknown primary |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392948/ https://www.ncbi.nlm.nih.gov/pubmed/32358736 http://dx.doi.org/10.1007/s10147-020-01687-w |
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