Universität zu Köln

Hessler, Nadine, Juenger, Stephanie T., Meissner, Anna-Katharina, Kocher, Martin, Goldbrunner, Roland and Grau, Stefan ORCID: 0000-0002-9742-527X (2022). Recurrent brain metastases: the role of resection of in a comprehensive multidisciplinary treatment setting. BMC Cancer, 22 (1). LONDON: BMC. ISSN 1471-2407

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Abstract

Background Treatment decision for recurrent symptomatic brain metastases (BM) is challenging with scarce data regarding surgical resection. We therefore evaluated the efficacy of surgery for pretreated, recurrent BM in a comprehensive multidisciplinary treatment setting. Methods In a retrospective single center study, patients were analyzed, who underwent surgical resection of recurrent BM between 2007 and 2019. Intracranial event-free survival (EFS) and overall survival (OS) were evaluated by Kaplan-Maier and Cox regression analysis. Results We included 107 patients with different primary tumor entities and individual previous treatment for BM. Primary tumors comprised non-small cell lung cancer (NSCLC) (37.4%), breast cancer (19.6%), melanoma (13.1%), gastro-intestinal cancer (10.3%) and other, rare entities (19.6%). The number of previous treatments of BM ranged from one to four; the adjuvant treatment modalities comprised: none, focal or whole brain radiotherapy, brachytherapy and radiosurgery. The median pre-operative Karnofsky Performance Score (KPS) was 70% (range 40-100) and improved to 80% (range 0-100) after surgery. The complication rate was 26.2% and two patients died during the perioperative period. Sixty-seven (62.6%) patients received postoperative local radio-oncologic and/or systemic therapy. Median postoperative EFS and OS were 7.1 (95%CI 5.8-8.2) and 11.1 (95%CI 8.4-13.6) months, respectively. The clinical status (postoperative KPS >= 70 (HR 0.27 95%CI 0.16-0.46; p < 0.001) remained the only independent factor for survival in multivariate analysis. Conclusions Surgical resection of recurrent BM may improve the clinical status and thus OS but is associated with a high complication rate; therefore a very careful patient selection is crucial.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hessler, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Stephanie T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, Anna-Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED orcid.org/0000-0002-9742-527X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-671375
DOI:	10.1186/s12885-022-09317-6
Journal or Publication Title:	BMC Cancer
Volume:	22
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2407
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROGNOSTIC-FACTORS; MANAGEMENT Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67137