gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Outcome of Patients with Cerebral Metastasis undergoing iMRI-guided Tumor Resection

Meeting Abstract

  • Christian Senft - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main
  • Florian Geßler - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main
  • Stephan Dützmann - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main
  • Patrick Harter - Universitätsklinikum Frankfurt, Edinger Institut, Frankfurt am Main
  • Kea Franz - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main
  • Volker Seifert - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch233

doi: 10.3205/14dgch233, urn:nbn:de:0183-14dgch2333

Veröffentlicht: 21. März 2014

© 2014 Senft et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: In contrast to glioma surgery, the value of radiologically complete resection and use of surgical adjuncts to optimize the extent of resection are not well established for patients with cerebral metastasis (CM). Our aim was to report on the outcome of patients undergoing intended complete resection of CM using intraoperative MRI guidance.

Material and methods: Retrospective analysis of our prospectively collected database of patients undergoing resection of a histopathologically proven CM with the use of an intraoperative MRI.

Results: 18 patients were included in this analysis. Median age was 65 years. Median follow-up was 16.7 months. All patients were in good clinical condition (EGOG 0 and 1) and harbored single CM. In three patients (16.7%), iMRI revealed residual contrast enhancing tissue when tumor resection was thought to be complete. In all three cases, this tissue was resected and showed to be infiltrative tumor on histopathological assessment. In four patients, 5-ALA was additionally used, but only one of these tumors (25%) exhibited red fluorescence under blue light. Early postoperative MRI confirmed complete resection of contrast enhancing tissue in all patients (100%). Kaplan Meier analysis rendered a median overall survival following CM resection of 22.6 months (95%-CI: 4.1–41.2).

Conclusion: CMs are not encapsulated, but infiltratively growing tumors. Therefore, intraoperative MRI as a surgical adjunct enhances completeness of tumor resection. Aggressive surgical treatment of single CMs appears to translate to a survival benefit.