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Published in: Acta Neurochirurgica 3/2013

01-03-2013 | Clinical Article - Brain Tumours

Retrospective study of 127 surgically treated patients with multiple brain metastases: indication, prognostic factors, and outcome

Authors: Gabriele Schackert, Claudia Lindner, Saskia Petschke, Mario Leimert, Matthias Kirsch

Published in: Acta Neurochirurgica | Issue 3/2013

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Abstract

Background

Metastases are the most frequent tumours in the brain. At the time of diagnosis, more than 50% of patients present with multiple lesions. The goal of our retrospective investigation was to evaluate the outcome of patients who undergo surgery for multiple cerebral metastases and to determine prognostic factors.

Methods

We included 127 patients with multiple brain metastases in the study. The median number of metastases was three. All patients were operated on for at least one lesion. The indications for surgery were: large tumours ≥27 cm3, metastases of unknown primaries at the time of diagnosis, and space-occupying cerebellar lesions. If possible, adjuvant WBRT was applied.

Results

The median MST of the whole group was 6.5 months; for patients with complete resection, 10.6 months. According to the RPA classification the MST ranged between 19.4 (class I), 7.8 (class II), and 3.4 months (class III) (p < 0.001). KPS > 70 had a significant influence on MST (9.1 months vs. 3.4 months, p < 0.001), the number of lesions: 2–4 vs. >4 (p = 0.046), and postoperative WBRT in multivariate analysis (p = 0.026). Age was not a significant factor. The 2-year survival rate was 15% and the 3-year survival rate 10%.

Conclusions

Favourable factors for prolonged survival were complete resection of all lesions, no more than four metastases, RPA-class I and adjuvant WBRT. The resection of large lesions, while leaving smaller residual ones, did not result in increased survival.
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Metadata
Title
Retrospective study of 127 surgically treated patients with multiple brain metastases: indication, prognostic factors, and outcome
Authors
Gabriele Schackert
Claudia Lindner
Saskia Petschke
Mario Leimert
Matthias Kirsch
Publication date
01-03-2013
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 3/2013
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-012-1606-8

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