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Neurosurgical resection for locally recurrent brain metastasis
Alexander F C Hulsbergen1,2, Abdullah M Abunimer1, Fidelia Ida1,3
1Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Neuro-Oncology
|July 16, 2021
Summary
Repeat craniotomy for recurrent brain metastases offers favorable outcomes in selected patients. While recurrence impacts overall survival, it does not affect intracranial control, suggesting craniotomy is a viable option for prognostically favorable cases.
Area of Science:
- Neurosurgery
- Neuro-oncology
- Oncology
Background:
- The role of repeat craniotomy for locally recurrent brain metastases (LRBMs) is debated.
- This study investigates long-term oncological outcomes in LRBM patients.
Purpose of the Study:
- To analyze long-term oncological outcomes in patients with locally recurrent brain metastases (LRBMs) undergoing craniotomy.
- To compare outcomes of LRBMs with newly diagnosed brain metastases (NDBMs).
Main Methods:
- Retrospective analysis of 180 patients with LRBMs undergoing craniotomy.
- Assessment of overall survival (OS) and intracranial control (ICC) stratified by molecular profile and treatment.
- Propensity score matching to compare LRBMs with NDBMs.
Main Results:
- Median survival after LRBM resection was 13.8 months, varying by molecular profile.
- 56.7% of patients experienced intracranial recurrence (median time 5.6 months).
- LRBM patients were younger, more likely to have targetable mutations, and received less adjuvant radiation than NDBMs. Matched LRBM patients had shorter OS but similar ICC compared to NDBMs.
Conclusions:
- Craniotomy for LRBMs can yield favorable outcomes in selected patients with good prognostic characteristics.
- Recurrent status predicts shorter OS but not ICC.
- Craniotomy is a potential treatment option for prognostically favorable LRBM patients.
