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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Carmustine-associated perioperative complications in recurrent glioblastoma

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  • Steffen-Ulrich Pauli - Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Deutschland
  • Dieter Class - Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Deutschland
  • Raimund Firsching - Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1705

doi: 10.3205/10dgnc176, urn:nbn:de:0183-10dgnc1760

Published: September 16, 2010

© 2010 Pauli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Objective: Carmustine wafers are commonly used for local delivery of chemotherapeutics to glioblastoma. Various complications of carmustine wafers have been reported. The aim of this study is to identify carmustine-associated complications in recurrent glioblastoma

Methods: In a prospective study, 11 patients were operated on for recurrent glioblastoma and carmustine wafers were implanted. The postoperative course of events was compared to 11 non-selected consecutive patients undergoing surgery for recurrent glioblastoma without carmustine wafers. Perioperative morbidity and complications with infection, CSF leak, delayed wound healing, seizures, symptomatic severe edema, meningitis, pulmonary embolism and deep-vein thrombosis within 3 months of surgery was recorded for these patients.

Results: Patients in the carmustine group had an overall complication rate of 5 out of 11 (45%) versus 1 out of 11 (9%) in the non-carmustine group. Delayed wound healing in 3 patients (27% ) and wound infection in 2 of 11 patients (18%), cerebrospinal fluid leak in 3 of 11 (27%), deep-vein thrombosis and pulmonary embolism in 1 patient were observed in the carmustine group. In the non-carmustine group seizures and symptomatic severe edema was observed in 1 patient. Because of these complications, an additional second hospitalisation with a mean duration of 16,6 days was necessary in 5 cases of the carmustine group.

Conclusions: The use of carmustine wafers is associated with increased perioperative morbidity. This risk is justified when outweighed by the desired benefit of a prolonged survival with acceptable quality of life. This benefit remains to be verified with adequate numbers of patients.