Neurological Surgery No Shinkei Geka Volume 46, Issue 3 (March 2018)

Surgical Resection of Metastatic Brain Tumors:Risk of Local Recurrence and Leptomeningeal Dissemination, and Implications for Individualized Treatment Yoko NAKASU 1 , Koichi MITSUYA 1 , Shoichi DEGUCHI 1 , Nakamasa HAYASHI 1 , Hideyuki HARADA 2 1Division of Neurosurgery, Shizuoka Cancer Center 2Division of Radiation Therapy, Shizuoka Cancer Center Keyword: dissemination , metastatic brain tumor , radiation therapy , recurrence , resection pp.185-195
Published Date 2018/3/10
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 Metastatic brain tumors are important complications in the overall management of cancers. We sought to determine the risk of local recurrence and leptomeningeal carcinomatosis(LC)in patients treated with surgical resection and adjuvant radiation therapy. We retrospectively reviewed 173 consecutive patients with metastatic brain tumors managed by surgical resection between 2002 and 2015 in a single institution. Eighty-seven percent of the patients underwent postoperative adjuvant radiotherapy. The median overall survival from surgery was 9.8 months. Thirty of 173 patients(17.3%)developed local recurrence and 14(8.1%)developed LC following surgery. Male sex(hazard ratio(HR):2.8, 95% confidence interval(CI):1.0-10.0), colon cancer(HR:6.5, 95% CI:2.2-24.2), and no postoperative radiation(HR:5.6, 95% CI:2.1-13.7)were identified as risk factors of local recurrence in multivariate analysis. Female sex(HR:4.4, 95% CI:1.2-20.9)and recursive partitioning analysis(RPA)class 3(HR:1.0e+9, 95%CI:1.7-)were identified as risk factors of LC in multivariate analysis. Our retrospective review showed that individualized treatment with surgical resection followed by adjuvant radiation therapy is a safe and feasible method to control metastatic brain tumors in the real world.

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Neurological Surgery 脳神経外科
46巻3号 (2018年3月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院