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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Impact of pre-OP frailty-scores on mortality after resection of limited brain metastases

Meeting Abstract

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  • Laila Siam - Department of Neursurgery, University Medical Center Göttingen, Göttingen, Germany
  • Annalen Bleckmann - Department of Hematology/Oncology, University Medical Center Göttingen, Göttingen, Germany; Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
  • Benjamin Kirchner - Department of Hematology/Oncology, University Medical Center Göttingen, Göttingen, Germany
  • Florian Stockhammer - Department of Neursurgery, University Medical Center Göttingen, Göttingen, Germany
  • Veit Rohde - Department of Neursurgery, University Medical Center Göttingen, Göttingen, Germany
  • Tobias Pukrop - Department of Hematology/Oncology, University Medical Center Göttingen, Göttingen, Germany

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 027

doi: 10.3205/15dgnc425, urn:nbn:de:0183-15dgnc4250

Published: June 2, 2015

© 2015 Siam et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: More than 25% of all patients with systemic malignancies develop brain metastases in the course of their disease. Neurosurgical resection is one of the established local treatment modalities in the case of limited numbers. However, pre-operative clinical prediction tools that could be used to better assess the survival after neurosurgery are missing. The recent scores for patients with brain metastasis are based on the status pre-radiotherapy (whole brain radiation) and is not restricted for limited numbers of brain metastases. Here, we aimed to determine the impact of different pro-surgery assessed frailty scores on mortality after pre-neurosurgical resection of brain metastases.

Method: Different fragility scores were retrospectively calculated that are capable to evaluate the patients in terms of self-sufficiency, activity and self-determination (ECOG- Status, Karnofsky-Index, Barthel-Index, ASA-Classification and Katz-Index). Additionally, blood parameters were calculated.

Results: 100 patients could be included in this retrospective study. The cohort consisted of 52 patients with NSCLC, 27 patients with breast cancer, 8 patients with colorectal carcinoma and 13 patients with kidney cancer. The following scores ECOG-Status, Karnofsky-Index, Barthel-Index, and Katz-Index were able to predict the outcome while the ASA-Classification and all tested blood parameters weren't. Interestingly, the only score which was independent from the other significant ones was the Katz-Index after multivariate testing (logrank p=0.04).

Conclusions: Pre-operative frailty status measurements represent a powerful predictor of resection outcome of brain metastases. Therefore, we propose the assessment of the simple and reproducible Katz-Index into pre-resection riskscore to better startifiy before surgical intervention. A current prosepective study is already ongoing to underline the retospective results and over 80 patients are already included.