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131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Patients with scull base metastases benefit from interdisciplinary tumor resection

Meeting Abstract

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  • Claudia Lindner - Neurochirurgie, Neurochirurgie, Dresden
  • Thomas Zahnert - Hals-Nasen und Ohrenklinik, Dresden
  • Gabriele Schackert - Neurochirurgie, Neurochirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch159

doi: 10.3205/14dgch159, urn:nbn:de:0183-14dgch1598

Published: March 21, 2014

© 2014 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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Introduction: Metastases are the most frequent tumors in the brain. Standard treatment comprises surgery and whole brain radiation therapy (WBRT) resulting in an overall survival time (OST) of 3 - 8 months. The goal of our retrospective investigation was to evaluate the prognosis of scull base metastases after interdisciplinary neurosurgical/otolaryngological resection and to search for the main prognostic factors that influence the survival of the patients.

Material and methods: 17 patients with scull base metastases and tumor growth in the paranasal sinuses were included in our retrospective study. All patients were operated interdisciplinary. Data acquisition was based on patient´s records, clinical cancer registry, and local health authority registry. The data were evaluated with respect to primary tumor, age, extracranial tumor status, number of intracranial metastases, symptoms, tumor size, operation time, complications, postoperative radiotherapy and overall survival.

Results: The median age at diagnosis was 62 years. All patients had one brain metastasis. The median tumor size was 64cm3. 3 patients had extracranial metastases. Preoperative radiotherapy was performed in 7 patients. All patients had preoperative cranial nerve palsies. Complete resection was possible in 9 patients. The median operation time was 306 minutes. 1 patient need a perioperative revision operation (bifrontal craniectomy after brain edema). According to the primary tumor 8 patients had adenocarcinoma of the paranasal sinuses, 1 rhabdomyosarcoma, 1 osteosarcoma, 1 mucodermoid carcinoma and the rest had distant primary tumors. Postoperative radiotherapy was performed in 9 patients. The median survival time was 67 months (11.8-122.2 months). The median 5 years- survival was 64.3%. The median 5-years survival for patients KPS<70% was 12.9%.

Conclusion: In our cohort patients with scull base metastases benefit from interdisciplinary surgery. The tumor size, operation time and preoperative radiotherapy are no predictors for the postoperative survival. Many long-term survivors can be expected, if active interdisciplinary treatment is applied.