gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Investigation of the infiltration zone of brain metastases from various primaries: preliminary data of a prospective monocentric study

Meeting Abstract

  • C. Lindner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden
  • M. Leimert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden
  • M. Kirsch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden
  • D. Krex - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden
  • K. Geiger - Institut für Pathologie, Universitätsklinikum Carl Gustav Carus Dresden
  • G. Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus Dresden

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.03.02

DOI: 10.3205/11dgnc189, URN: urn:nbn:de:0183-11dgnc1893

Published: April 28, 2011

© 2011 Lindner 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.


Outline

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Objective: It has long been believed that brain metastases are well circumscribed lesions without an infiltration zone, and are thus a good target for surgical treatment. Recent publications demonstrated that there is an infiltration zone around brain metastases as well and that the depth of infiltration may vary between the different primaries. The goal of our prospective study was to investigate the infiltration zone around cerebral metastases of different primaries by taking biopsies out of the surrounding tissue.

Methods: Between 2009 and 2010, 23 patients with brain metastases of different primaries, located in non-eloquent areas were enrolled in a prospective clinical trial after written consent. The study was approved by the local ethics committee, No 102042009. During surgery, whenever possible, en-bloc resection was performed. At the end of the procedure, biopsies were taken out of the adjacent tissue for histopathological examination. All tissues were examined for infiltration of cancer cells by immunohistochemistry. SPSS was applied for statistics.

Results: Altogether 14 men and 9 women with brain metastases were enrolled in our study. The most common primaries were: lung (35%), kidney (17%) and malignant melanoma (13%). The median age was 58 years (range 29-78). All patients had an early MRI with contrast medium within 48 hours after surgery, confirming the complete resection of tbe lesion. In 7 patients (30.4%), tumor cells were detected in at least one of the biopsies. The distribution between the different primaries was equal and therefore not significant.

Conclusions: Despite microscopically complete resection of brain metastases confirmed by early MRI, we demonstrate that tumor cells infiltrate the adjacent tissue. In our study the depth of the infiltration zone was not verified. An enlargement of our cohort is necessary, in order to answer the question, as to whether the infiltration zone varies between metastases of different primaries, which might have an implication for future surgical strategies.