Hulsbergen, Alexander F C; Abunimer, Abdullah M; Ida, Fidelia; Kavouridis, Vasileios K; Cho, Logan D; Tewarie, Ishaan A; Mekary, Rania A; Schucht, Philippe; Phillips, John G; Verhoeff, Joost J C; Broekman, Marike L D; Smith, Timothy R (2021). Neurosurgical resection for locally recurrent brain metastasis. Neuro-Oncology, 23(12), pp. 2085-2094. Oxford University Press 10.1093/neuonc/noab173
Full text not available from this repository.BACKGROUND
In patients with locally recurrent brain metastases (LRBMs), the role of (repeat) craniotomy is controversial. This study aimed to analyze long-term oncological outcomes in this heterogeneous population.
METHODS
Craniotomies for LRBM were identified from a tertiary neuro-oncological institution. First, we assessed overall survival (OS) and intracranial control (ICC) stratified by molecular profile, prognostic indices, and multimodality treatment. Second, we compared LRBMs to propensity score-matched patients who underwent craniotomy for newly diagnosed brain metastases (NDBM).
RESULTS
Across 180 patients, median survival after LRBM resection was 13.8 months and varied by molecular profile, with >24 months survival in ALK/EGFR+ lung adenocarcinoma and HER2+ breast cancer. Furthermore, 102 patients (56.7%) experienced intracranial recurrence; median time to recurrence was 5.6 months. Compared to NDBMs (n = 898), LRBM patients were younger, more likely to harbor a targetable mutation and less likely to receive adjuvant radiation (p < 0.05). After 1:3 propensity matching stratified by molecular profile, LRBM patients generally experienced shorter OS (hazard ratio 1.67 and 1.36 for patients with or without a mutation, p < 0.05) but similar ICC (hazard ratio 1.11 in both groups, p > 0.20) compared to NDBM patients with similar baseline. Results across specific molecular subgroups suggested comparable effect directions of varying sizes.
CONCLUSIONS
In our data, patients with LRBMs undergoing craniotomy comprised a subgroup of brain metastasis patients with relatively favorable clinical characteristics and good survival outcomes. Recurrent status predicted shorter OS but did not impact ICC. Craniotomy could be considered in selected, prognostically favorable patients.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery |
UniBE Contributor: |
Schucht, Philippe |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1523-5866 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Nicole Söll |
Date Deposited: |
08 Nov 2021 13:39 |
Last Modified: |
05 Dec 2022 15:53 |
Publisher DOI: |
10.1093/neuonc/noab173 |
PubMed ID: |
34270740 |
Uncontrolled Keywords: |
craniotomy local recurrence molecular markers propensity score matching recurrent brain metastasis |
URI: |
https://boris.unibe.ch/id/eprint/159939 |
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