Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues

We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Progn...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tunc Faik Ersoy, Neda Mokhtari, Daniel Brainman, Björn Berger, Attila Salay, Philipp Schütt, Florian Weissinger, Alexander Grote, Matthias Simon
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cerebellar metastases neurosurgery complications prognostic factors survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/bb3fa6be3de648439670fe3f48d4acef
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:bb3fa6be3de648439670fe3f48d4acef
record_format	dspace
spelling	oai:doaj.org-article:bb3fa6be3de648439670fe3f48d4acef2021-11-11T15:26:39ZSurgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues10.3390/cancers132152632072-6694https://doaj.org/article/bb3fa6be3de648439670fe3f48d4acef2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5263https://doaj.org/toc/2072-6694We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Prognostic factors included clinical (but not radiological) hydrocephalus (medOS 11.3 vs. 5.2 months, <i>p</i> = 0.0374). Of note, a third of the patients with a KPI <70% or multiple metastases survived >12 months. Chemotherapy played a prominent prognostic role (medOS 15.5 vs. 2.3, <i>p</i> < 0.0001) possibly reflecting advances in treating systemic vis-à-vis controlled CNS disease. Major neurological (≥30 days), surgical and medical complications (CTCAE III–V) were observed in 8.2%, 13.7%, and 9.6%, respectively. The occurrence of a major complication markedly reduced survival (10.7 vs. 2.5 months, <i>p</i> = 0.020). The presence of extracerebral metastases did not significantly influence OS. Postponing staging was not associated with more complications or shorter survival. Together these data argue for individualized decision making which includes offering surgery in selected cases with a presumably adverse prognosis and also occasional urgent operations in cases without a preoperative oncological work-up. Complication avoidance is of utmost importance.Tunc Faik ErsoyNeda MokhtariDaniel BrainmanBjörn BergerAttila SalayPhilipp SchüttFlorian WeissingerAlexander GroteMatthias SimonMDPI AGarticlecerebellar metastasesneurosurgerycomplicationsprognostic factorssurvivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5263, p 5263 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cerebellar metastases neurosurgery complications prognostic factors survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cerebellar metastases neurosurgery complications prognostic factors survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Tunc Faik Ersoy Neda Mokhtari Daniel Brainman Björn Berger Attila Salay Philipp Schütt Florian Weissinger Alexander Grote Matthias Simon Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
description	We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Prognostic factors included clinical (but not radiological) hydrocephalus (medOS 11.3 vs. 5.2 months, <i>p</i> = 0.0374). Of note, a third of the patients with a KPI <70% or multiple metastases survived >12 months. Chemotherapy played a prominent prognostic role (medOS 15.5 vs. 2.3, <i>p</i> < 0.0001) possibly reflecting advances in treating systemic vis-à-vis controlled CNS disease. Major neurological (≥30 days), surgical and medical complications (CTCAE III–V) were observed in 8.2%, 13.7%, and 9.6%, respectively. The occurrence of a major complication markedly reduced survival (10.7 vs. 2.5 months, <i>p</i> = 0.020). The presence of extracerebral metastases did not significantly influence OS. Postponing staging was not associated with more complications or shorter survival. Together these data argue for individualized decision making which includes offering surgery in selected cases with a presumably adverse prognosis and also occasional urgent operations in cases without a preoperative oncological work-up. Complication avoidance is of utmost importance.
format	article
author	Tunc Faik Ersoy Neda Mokhtari Daniel Brainman Björn Berger Attila Salay Philipp Schütt Florian Weissinger Alexander Grote Matthias Simon
author_facet	Tunc Faik Ersoy Neda Mokhtari Daniel Brainman Björn Berger Attila Salay Philipp Schütt Florian Weissinger Alexander Grote Matthias Simon
author_sort	Tunc Faik Ersoy
title	Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
title_short	Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
title_full	Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
title_fullStr	Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
title_full_unstemmed	Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
title_sort	surgical treatment of cerebellar metastases: survival benefits, complications and timing issues
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/bb3fa6be3de648439670fe3f48d4acef
work_keys_str_mv	AT tuncfaikersoy surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT nedamokhtari surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT danielbrainman surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT bjornberger surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT attilasalay surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT philippschutt surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT florianweissinger surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT alexandergrote surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues AT matthiassimon surgicaltreatmentofcerebellarmetastasessurvivalbenefitscomplicationsandtimingissues
_version_	1718435331612606464

Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues

Ejemplares similares