Research article summary (published 29 Sep 2009):

The results of resection after stereotactic radiosurgery for brain metastases.

Full Abstract

OBJECT: Radiosurgery for brain metastasis fails in some patients, who require further surgical care. In this paper the authors' goal was to evaluate prognostic factors that correlate with the survival of patients who require a resection of a brain metastasis after stereotactic radiosurgery (SRS). METHODS: During the last 14 years when surgical navigation systems were routinely available, the authors identified 58 patients who required resection for various brain metastases after SRS. The median patient age was 54 years. Prior adjuvant treatment included whole-brain radiation therapy alone (17 patients), chemotherapy alone (9 patients), both radiotherapy and chemotherapy (10 patients), and prior resection before SRS (8 patients). The median target volumes at the time of SRS and resection were 7.7 cm(3) (range 0.5-24.9 cm(3)) and 15.5 cm(3) (range 1.3-81.2 cm(3)), respectively. RESULTS: At a median follow-up of 7.6 months, 8 patients (14%) were living and 50 patients (86%) had died. The survival after surgical removal was 65, 30, and 16% at 6, 12, and 24 months, respectively (median survival after resection 7.7 months). The local tumor control rate after resection was 71, 62, and 43% at 6, 12, and 24 months, respectively. A univariate analysis revealed that patient preoperative recursive partitioning analysis classification, Karnofsky Performance Scale status, systemic disease status, and the interval between SRS and resection were factors associated with patient survival. The mortality and morbidity rates of resection were 1.7 and 6.9%, respectively. CONCLUSIONS: In patients with symptomatic mass effect after radiosurgery, resection may be warranted. Patients who had delayed local progression after SRS (> 3 months) had the best outcomes after resection.

Author information

Author/s: Kano, Hideyuki (H); Kondziolka, Douglas (D); Zorro, Oscar (O); Lobato-Polo, Javier (J); Flickinger, John C (JC); Lunsford, L Dade (LD);

Affiliation: Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of neurosurgery (J Neurosurg), published in United States. (Language: eng)

Reference: 2009-Oct; vol 111 (issue 4) : pp 825-31

Dates: Created 2009/10/02; Completed 2009/10/23;

PMID: 19425892, status: MEDLINE (last retrieval date: 10/23/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult Aged Aged, 80 and over Brain Neoplasms - secondary; surgery Disease Progression Female Follow-Up Studies Humans

Kaplan-Meiers Estimate Male Middle Aged Radiosurgery - methods Reoperation - methods Risk Assessment Time Factors Treatment Outcome

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