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Acta Neurochirurgica
Published in: Acta Neurochirurgica 9/2015

01-09-2015 | Clinical Article - Brain Tumors

Early postoperative magnet resonance tomography after resection of cerebral metastases

Authors: Marcel A. Kamp, Marion Rapp, Julia Bühner, Philipp J. Slotty, Dorothea Reichelt, Hosai Sadat, Maxine Dibué-Adjei, Hans-Jakob Steiger, Bernd Turowski, Michael Sabel

Published in: Acta Neurochirurgica | Issue 9/2015

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Abstract

Background

In contrast to malignant gliomas, the impact of an early postoperative MRI after surgery of cerebral metastasis is still unclear. The present study analyses early MRI-based postoperative resection controls and incidence of in-brain progression in 116 patients suffering from 130 cerebral metastases.

Methods

The extent of surgical resection was verified by an early postoperative contrast-enhanced 1.5-T MRI within 72 h after surgery of cerebral metastases and correlated with in-brain progression, leptomeningeal carcinomatosis, and progression-free survival.

Results

MRI confirmed complete resection was seen in 80 out of 130 metastases (61.5 %). In 24 metastases (18.5 %), no final decision on degree of resection could be made. Residual tumor was seen in 26 cases (20 %). Local in-brain progression was observed in 40 of 130 (30.8 %) cases. The incidence of in-brain progression significantly correlated with dural contact of the metastasis (p < 0.05) and residual tumor on early postoperative MRI (p < 0.0001). The odds ratio for local recurrence with residual tumor is 8.2-fold compared to no residual tumor.

Conclusions

Residual tumor after metastasis extirpation was shown in nearly 20 % of patients by an early postoperative MRI and significantly correlated with local in-brain progression. Furthermore, dural contact of cerebral metastases was identified as a risk factor for local recurrence. Further studies are mandatory to clearly identify the incidence of incomplete resections of cerebral metastases and their oncologic impact. An early postoperative MRI after resection of cerebral metastases is recommended as residual tumor promotes local recurrence.
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Metadata
Title
Early postoperative magnet resonance tomography after resection of cerebral metastases
Authors
Marcel A. Kamp
Marion Rapp
Julia Bühner
Philipp J. Slotty
Dorothea Reichelt
Hosai Sadat
Maxine Dibué-Adjei
Hans-Jakob Steiger
Bernd Turowski
Michael Sabel
Publication date
01-09-2015
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 9/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-015-2479-4

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