Int. J. Mol. Sci. 2013, 14(5), 8708-8718; doi:10.3390/ijms14058708
Article

Surgical Resection of Brain Metastases—Impact on Neurological Outcome

Department of Neurosurgery, University of Regensburg Medical Center, Franz Josef Strauß Allee 11, Regensburg 93053, Germany
* Author to whom correspondence should be addressed.
Received: 5 February 2013; in revised form: 13 April 2013 / Accepted: 16 April 2013 / Published: 24 April 2013
(This article belongs to the Special Issue Brain Metastasis)
PDF Full-text Download PDF Full-Text [856 KB, uploaded 24 April 2013 11:23 CEST]
Abstract: Brain metastases (BM) develop in about 30% of all cancer patients. Surgery plays an important role in confirming neuropathological diagnosis, relieving mass effects and improving the neurological status. To select patients with the highest benefit from surgical resection, prognostic indices (RPA, GPA) have been formulated which are solely focused on survival without considering neurological improvement. In this study we analyzed the impact of surgical resection on the neurological status in addition to overall survival in 206 BM patients. Surgical mortality and morbidity was 0.0% and 10.3% respectively. New neurologic deficits occurred in 6.3% of all patients. The median overall survival was 6.3 months. Poor RPA class and short time interval between diagnosis of cancer and the occurrence of BM were independent factors predictive for poor survival. Improvement of neurological performance was achieved in 56.8% of all patients, with the highest improvement rate seen in patients presenting with increased intracranial pressure and hemiparesis. Notably, the neurological benefits were independent from RPA class. In conclusion, surgical resection leads to significant neurological improvement despite poor RPA class and short overall survival. Considering the low mortality and morbidity rates, resection should be considered as a valid option to increase neurological function and quality of life for patients with BM.
Keywords: resection; recurrence; survival; neurological status; prognosis; brain metastases

Article Statistics

Load and display the download statistics.

Citations to this Article

Cite This Article

MDPI and ACS Style

Schödel, P.; Schebesch, K.-M.; Brawanski, A.; Proescholdt, M.A. Surgical Resection of Brain Metastases—Impact on Neurological Outcome. Int. J. Mol. Sci. 2013, 14, 8708-8718.

AMA Style

Schödel P, Schebesch K-M, Brawanski A, Proescholdt MA. Surgical Resection of Brain Metastases—Impact on Neurological Outcome. International Journal of Molecular Sciences. 2013; 14(5):8708-8718.

Chicago/Turabian Style

Schödel, Petra; Schebesch, Karl-Michael; Brawanski, Alexander; Proescholdt, Martin A. 2013. "Surgical Resection of Brain Metastases—Impact on Neurological Outcome." Int. J. Mol. Sci. 14, no. 5: 8708-8718.

Int. J. Mol. Sci. EISSN 1422-0067 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert