gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Impact of surgical resection in recurrent brain metastases from lung cancer

Meeting Abstract

  • M. Al-Zabin - Klinik für Neurochirurgie, Universitätsklinik Regensburg
  • M. Proescholdt - Klinik für Neurochirurgie, Universitätsklinik Regensburg
  • W. Ullrich - Klinik für Neurochirurgie, Universitätsklinik Regensburg
  • A. Brawanski - Klinik für Neurochirurgie, Universitätsklinik Regensburg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP08-12

DOI: 10.3205/09dgnc340, URN: urn:nbn:de:0183-09dgnc3402

Published: May 20, 2009

© 2009 Al-Zabin et al.
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Outline

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Objective: Brain metastases develop in 25% of patients with lung cancer during the course of their disease, accounting for 40–60% of all cases of parenchymal brain metastases. The prognosis of this disease is dismal with a median survival time of approximately 6 months. Surgical resection has been shown to be an effective treatment strategy for lung cancer associated solitary brain metastases. However, there are no reports about the potential benefit of microsurgical resection in patients with recurrent brain metastases. Therefore, we retrospectively analyzed 26 cases of patients with recurrent brain metastases from lung cancer treated in our institution from 1993 until 2007. More specifically, we analyzed whether surgery can improve focal neurological impairment and the overall performance status in these patients.

Methods: We investigated a group of patients with recurrent brain metastases caused by lung cancer (n=26) with a mean age of 54.9 years (max: 78.2; min: 38.9); 6 female (23.1%) and 20 male (76.9%). All patients had solitary metastases; at the time of surgery the underlying disease was under control. 15.4% of all patients had a small cell lung cancer (SCLC) and 84.6% a non-small cell lung cancer (NSCLC).

Results: 16 patients (61.5%) presented with a neurological impairment preoperatively. From this group 8 patients (50%) showed complete, 3 patients (18.8) incomplete, and 5 patients (31.2%) showed no improvement of the neurological deficit. Preoperatively, the median Karnofsky performance score was 90 (max: 100; min: 70), which significantly improved to a median score of 100 (max: 100; min: 90) after surgery (p=0.006). The median overall survival was 36.2 weeks (max: 143.1; min: 2.4) and was not correlated to age or preoperative Karnofsky-Index (p>0.05). All patients died from extracerebral disease, the majority (80.8%) from progress of the underlying disease.

Conclusions: Our data show that even in a very palliative situation such as recurrent brain metastases, surgical evacuation can be beneficial. Although, as expected, the overall survival was short, resection of the recurrent metastatic tumor significantly reduced neurological impairment and improved the overall performance status. This indicates that surgical treatment can contribute to a better quality of life in patients with recurrent metastatic brain tumors derived from lung cancer.