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

Cancers

Florian Weissinger¹  Björn Berger²  Neda Mokhtari³  Daniel Brainman³  Matthias Simon³  Alexander Grote³  Tunc Faik Ersoy³  Attila Salay⁴  Philipp Schütt⁵ 

[1] Department of Hematology, Oncology and Palliative Care, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Schildescher Str. 99, 33611 Bielefeld, Germany;Department of Neuroradiology, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Burgsteig 13, 33617 Bielefeld, Germany;Department of Neurosurgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Burgsteig 13, 33617 Bielefeld, Germany;Department of Radiotherapy, Brüderkrankenhaus St. Josef Paderborn, Husener Str. 46, 33098 Paderborn, Germany;Oncological Practice Gütersloh, Brunnenstraße 14, 33332 Gütersloh, Germany;

关键词: cerebellar metastases;    neurosurgery;    complications;    prognostic factors;    survival;   

DOI  :  10.3390/cancers13215263

来源: DOAJ

【 摘 要 】

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, p = 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, p < 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, p = 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.

【 授权许可】

Unknown