Universität zu Köln

Kamp, Marcel A., Dibue, Maxine, Niemann, Lena, Reichelt, Dorothea C., Felsberg, Joerg, Steiger, Hans-Jakob ORCID: 0000-0002-8249-2998, Szelenyi, Andrea, Rapp, Marion ORCID: 0000-0003-2343-244X and Sabel, Michael (2012). Proof of principle: supramarginal resection of cerebral metastases in eloquent brain areas. Acta Neurochir., 154 (11). S. 1981 - 1987. WIEN: SPRINGER WIEN. ISSN 0942-0940

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Abstract

Cerebral metastases are not sharply delimitatable; therefore, microsurgical circumferential stripping of intracerebral metastases is often insufficient for preventing local tumor recurrence. Supramarginal resection significantly improves local tumor control but was suggested not to be suitable for metastases in eloquent brain areas. Therefore, we retrospectively analyzed a series of patients with cerebral metastases situated in eloquent areas for newly occurring neurologic deficits after supramarginal resection performed as awake surgery. A retrospective analysis was performed for all patients who underwent supramarginal resection for a cerebral metastasis performed as awake surgery between June 2011 and April 2012. All metastases were localized in eloquent brain areas. Pre- and postsurgical neurologic status was documented as well as data regarding the primary cancer and histopathologic data. Postoperative MRI within 72 h was scheduled routinely to verify complete resection. A total of 19 patients underwent awake surgery for a cerebral metastasis in eloquent brain areas. Surgery was well tolerated in all patients. Neurologic symptoms improved in five patients after surgery. In three patients, neurologic deficits existing before surgery worsened. The postoperative median National Institute of Health Stroke Scale (NIHSS) score did not differ from the preoperative value. Awake surgery is a feasible tool for metastases in eloquent areas, minimizing postoperative neurologic deficits and morbidity. Therefore, eloquently situated metastases may also be eligible for supramarginal resection. Further studies are needed in order to analyze the benefit of this method in achieving better tumor control.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kamp, Marcel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dibue, Maxine UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemann, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Reichelt, Dorothea C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Felsberg, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Steiger, Hans-Jakob UNSPECIFIED orcid.org/0000-0002-8249-2998 UNSPECIFIED Szelenyi, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Rapp, Marion UNSPECIFIED orcid.org/0000-0003-2343-244X UNSPECIFIED Sabel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-480321
DOI:	10.1007/s00701-012-1463-5
Journal or Publication Title:	Acta Neurochir.
Volume:	154
Number:	11
Page Range:	S. 1981 - 1987
Date:	2012
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	0942-0940
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUPPLEMENTARY MOTOR AREA; 5-AMINOLEVULINIC ACID; SINGLE METASTASES; RANDOMIZED-TRIAL; SURGERY; RADIOTHERAPY; FLUORESCENCE; RADIOSURGERY; LANGUAGE; LESIONS Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48032