Top

Acta Neurochirurgica

Published in:

01-05-2019 | Magnetic Resonance Imaging | Original Article - Brain Tumors

Outcome after surgery in supratentorial and infratentorial solitary brain metastasis

Authors: Rik Demaerel, Johannes van Loon, Frank Van Calenbergh

Published in: Acta Neurochirurgica | Issue 5/2019

Abstract

Background

The aim of this retrospective study was to investigate and compare the outcome after surgery in patients with a supratentorial solitary metastasis (SSM) and an infratentorial solitary metastasis (ISM). A worse prognosis has been reported in ISM.

Methods

Fifty-two patients with a newly diagnosed solitary brain metastasis on MRI were included to identify risk factors affecting the outcome. Key variables included tumor size, staging of the primary tumor, time span of presurgical work-up, and surgical technique. Outcome variables included postoperative complications, tumor recurrence, and mortality. Kaplan-Meier survival analysis was applied.

Results

Thirty patients with a SSM and 22 patients with an ISM underwent gross total resection. The tumor size did not have a statistical significant effect on survival. Presurgical work-up time was similar in SSM and ISM. Postoperative complications were more frequently encountered in ISM. Recurrence rate was comparable in SSM and ISM. Carcinomatous meningitis (CM) was more frequently seen in ISM, and CM was seen more often with the piecemeal resection technique. There was no statistical difference in overall survival between SSM and ISM.

Conclusions

This study identified factors that play a role in the outcome after surgery in patients with ISM and SSM on MRI. Postoperative complications seemed to be higher in ISM and CM was more often seen in ISM, but the worse prognosis in patients with ISM compared with SSM could not be confirmed.

Ahn JH, Lee SH, Kim S, Joo J, Yoo H, Lee SH, Shin SH, Gwak HS (2012) Risk for leptomeningeal seeding after resection for brain metastases: implication of tumor location with mode of resection. J Neurosurg 116:984–993CrossRefPubMed

Amer MH, Al-Sarraf M, Baker LH, Vaitkevicius VK (1978) Malignant melanoma and central nervous system metastases. Incidence, diagnosis, treatment and survival. Cancer 42:660–668CrossRefPubMed

Bougie E, Masson-Côté L, Mathieu D (2015) Comparison between surgical resection and stereotactic radiosurgery in patients with a single brain metastasis from non-small cell lung cancer. World Neurosurg 83:900–906CrossRefPubMed

Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC, Greenspoon J, Parney IF, Laack NNI, Ashman JB, Bahary J-P, Hadjipanayis CG, Urbanic JJ, Barker FG, Farace E, Khuntia D, Giannini C, Buckner JC, Galanis E, Roberge D (2017) Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTGN107C/CEC3): a multicenter, randomised, controlled, phase 3 trial. Lancet Oncol 18:1049–1060CrossRefPubMedPubMedCentral

Chaichana KL, Rao K, Gadkaree S, Dangelmajer S, Bettegowda C, Rigamonti D, Weingart J, Olivi A, Gallia GL, Brem H, Lim M, Quinones-Hinojosa A (2014) Factors associated with survival and recurrence for patients undergoing surgery of cerebellar metastases. Neurol Res 36:13–25CrossRefPubMed

Chamberlain MC (2008) Risk of neoplastic meningitis following surgical resection of cerebellar metastases. J Neuro-Oncol 89:105–107CrossRef

Enders F, Geisenberger C, Jungk C, Bermejo JL, Warta R, von Deimling A, Herold-Mende C, Unterberg A (2016) Prognostic factors and long-term survival in surgically treated brain metastases from non-small cell lung cancer. Clin Neurol Neurosurg 142:72–80CrossRefPubMed

Ferrara M, Bizzozzero L, Talamonti G, D'Angelo VA (1990) Surgical treatment of 100 single brain metastases. Analysis of the results. J Neurosurg Sci 34:303–308PubMed

Fuentes R, Bonfill X, Exposito J (2006) Surgery versus radiosurgery for patients with a solitary brain metastasis from non-small cell lung cancer. Cochrane Database Syst Rev 25:CD004840

10.

Fuentes R, Osorio D, Hernandez JE, Simancas-Racines D, Martinez-Zapata MJ, Bonfill Cosp X (2018) Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis. Cochrane Database Syst Rev 8:CD012086. https://doi.org/10.1002/14651858.CD012086.pub2 CrossRefPubMed

11.

Ghods A, Munoz L, Byrne R (2011) Surgical treatment of cerebellar metastases. Surg Neurol Int 2:159. https://doi.org/10.4103/2152-7806.89859 CrossRefPubMedPubMedCentral

12.

Hart MG, Grant R, Walker M, Dickinson H (2005) Surgical resection and whole brain radiation therapy versus whole brain radiation therapy alone for single brain metastases [electronic resource]. Cochrane Database Syst Rev 1:CD003292. https://doi.org/10.1002/14651858.CD003292.pub2 CrossRef

13.

Kamath SD, Kumthekar PU (2018) Immune checkpoint inhibitors for the treatment of central nervous system (CNS) metastatic disease. Front Oncol 8:414. https://doi.org/10.3389/fonc.2018.00414 CrossRefPubMedPubMedCentral

14.

Kamp MA, Rapp M, Bühner J, Slotty PJ, Reichelt D, Sadat H, Dibué-Adjei M, Steiger HJ, Turowski B, Sabel M (2015) Early postoperative magnet resonance tomography after resection of cerebral metastases. Acta Neurochir 157:1573–1580CrossRefPubMed

15.

Kitaoka K, Abe H, Aida T, Satoh M, Itoh T, Nakagawa Y (1990) Follow-up study on metastatic cerebellar tumor surgery. Neurol Med Chir 30:591–598CrossRef

16.

Le Rhun E, Taillibert S, Chamberlain MC (2013) Carcinomatous meningitis: leptomeningeal metastases in solid tumors. Surg Neurol Int 4:S265–S288CrossRefPubMedPubMedCentral

17.

Lee CH, Kim DG, Kim JW, Han JH, Kim YH, Park CK, Kim CY, Paek SH, Jung HW (2013) The role of surgical resection in the management of brain metastasis: a 17 year longitudinal study. Acta Neurochir 155:389–397CrossRefPubMed

18.

Mintz AH, Kestle J, Rathbone MP, Gaspar L, Hugenholtz H, Fisher B, Duncan G, Skingley P, Foster G, Levine M (1996) A randomized trial to assess the efficacy of surgery in addition to radiotherapy in patients with a single brain metastasis. Cancer 78:1470–1476CrossRefPubMed

19.

Muacevic A, Wowra B, Siefert A, Tonn JC, Steiger HJ, Kreth FW (2008) Microsurgery plus whole brain irradiation versus gamma knife surgery alone for treatment of single metastases to the brain: a randomized controlled multicenter phase III trial. J Neuro Oncol 87:299–307CrossRef

20.

Norris LK, Grossman SA, Olivi A (1997) Neoplastic meningitis following surgical resection of isolated cerebellar metastasis: a potentially preventable complication. J Neuro-Oncol 32:215–223CrossRef

21.

O'Neill BP, Iturria NJ, Link MJ, Pollock BE, Ballman KV, O'Fallon JR (2003) A comparison of surgical resection and stereotactic radiosurgery in the treatment of solitary brain metastases. Int J Radiat Oncol Biol Phys 55:1169–1176CrossRefPubMed

22.

Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, MacDonald JS, Young B (1990) A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322:494–500CrossRefPubMed

23.

Patel AJ, Suki D, Hatiboglu MA, Abouassi H, Shi W, Wildrick DM, Lang FF, Sawaya R (2010) Factors influencing the risk of local recurrence after resection of a single brain metastasis. J Neurosurg 113:181–189CrossRefPubMed

24.

Pavlidis N, Briasoulis E, Hainsworth J, Greco FA (2003) Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer 39:1990–2005CrossRefPubMed

25.

Roos DE, Smith JG, Stephens SW (2011) Radiosurgery versus surgery, both with adjuvant whole brain radiotherapy for solitary brain metastases: a randomized controlled trial. Clin Oncol 23:646–651CrossRef

26.

Saad S, Wang TJ (2015) Neurocognitive deficits after radiation therapy for brain malignancies. Am J Clin Oncol 38:634–640CrossRefPubMed

27.

Sandru A, Voinea S, Panaitescu E, Blidaru A (2014) Survival rates of patients with metastatic malignant melanoma. J Med Life 7:572–576PubMedPubMedCentral

28.

Siomin VE, Vogelbaum MA, Kanner AA, Lee SY, Suh JH, Barnett GH (2004) Posterior fossa metastases: risk of leptomeningeal disease when treated with stereotactic radiosurgery compared to surgery. J Neuro-Oncol 67:115–121CrossRef

29.

Sloan AE, Nock CJ, Einstein DB (2009) Diagnosis and treatment of melanoma brain metastasis: a literature review. Cancer Control 16:248–255CrossRefPubMed

30.

Song TW, Kim IY, Jung S, Jung TY, Moon KS, Jang WY (2017) Resection and observation for brain metastasis without prompt postoperative radiation therapy. J Korean Neurosurg Soc 60:667–675CrossRefPubMedPubMedCentral

31.

Stark AM, Tscheslog H, Buhl R, Held-Feindt J, Mehdorn HM (2005) Surgical treatment for brain metastases: prognostic factors and survival in 177 patients. Neurosurg Rev 28:115–119CrossRefPubMed

32.

Suki D, Abouassi H, Patel AJ, Sawaya R, Weinberg J, Groves MD (2008) Comparative risk of leptomeningeal disease after resection or stereotactic radiosurgery for solid tumor metastasis to the posterior fossa. J Neurosurg 108:248–257CrossRefPubMed

33.

Suki D, Hatiboglu MA, Patel A, Weinberg JS, Groves MD, Mahajan A, Sawaya R (2009) Comparative risk of leptomeningeal dissemination of cancer after surgery or stereotactic radiosurgery for a single supratentorial solid tumor metastasis. Neurosurgery 64:664–674CrossRefPubMed

34.

Sunderland G, Jenkinson M, Zakaria R (2016) Surgical management of posterior fossa metastases. J Neuro-Oncol 130:535–542CrossRef

35.

Tendulkar RD, Liu SW, Barnett GH, Vogelbaum MA, Toms SA, Jin T, Suh JH (2006) RPA classification has prognostic significance for surgically resected single brain metastasis. Int J Radiat Oncol Biol Phys 66:810–817CrossRefPubMed

36.

Tosoni A, Ermani M, Brandes AA (2004) The pathogenesis and treatment of brain metastases: a comprehensive review. Crit Rev Oncol Hematol 52:199–215CrossRefPubMed

37.

Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, Tans JT, Lambooij N, Metsaars JA, Wattendorff AR, Brand R, Hermans J (1993) Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery. Ann Neurol 33:583–590CrossRefPubMed

38.

Wroński M, Arbit E, Burt M, Galicich J (1995) Survival after surgical treatment of brain metastases from lung cancer: a follow-up study of 231 patients treated between 1976 and 1991. J Neurosurg 83:605–616CrossRefPubMed

Title: Outcome after surgery in supratentorial and infratentorial solitary brain metastasis
Authors: Rik Demaerel
Johannes van Loon
Frank Van Calenbergh
Publication date: 01-05-2019
Publisher: Springer Vienna
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Metastasis
Published in: Acta Neurochirurgica / Issue 5/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-03865-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome after surgery in supratentorial and infratentorial solitary brain metastasis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2019

Frameless stereotactic biopsy for precision neurosurgery: diagnostic value, safety, and accuracy

ioCT-guided percutaneous radiofrequency ablation for trigeminal neuralgia: how I do it

Extreme lateral supracerebellar infratentorial approach: how I do it

Going beyond scoring systems for cavernous sinus involvement in trans-sphenoidal pituitary surgery

Neurosurgical procedures performed during residency in Europe—preliminary numbers and time trends

Screening spreading depolarizations during epilepsy surgery