gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Risk factors for local in-brain progression after resection of cerebral metastases

Meeting Abstract

  • Christopher Munoz-Bendix - Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
  • Marion Rapp - Neurochirurgie Uniklinik Düsseldorf, Düsseldorf, Deutschland
  • Hans-Jakob Steiger - Universitätsklinikum Düsseldorf, Neurochirurgische Klinik, Düsseldorf, Deutschland
  • Michael Sabel - Klinik für Neurochirurgie, Medizinische Fakultät, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland
  • Marcel Alexander Kamp - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Duesseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.03.06

doi: 10.3205/17dgnc019, urn:nbn:de:0183-17dgnc0194

Published: June 9, 2017

© 2017 Munoz-Bendix et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Surgical treatment of cerebral metastases aims to achieve a long-lasting local control with a low morbidity. However, local recurrence occurs in up to 50 – 70% of surgically treated metastases, if not combined with an adjuvant radiation therapy. We aimed to identify risk factors of local brain-progression after surgical metastases resection.

Methods: Two hundred thirteen patients operated on in a seven-year period with cerebral metastases of a carcinoma or melanoma, were retrospectively studied. Occurrence of local in-brain-progression was correlated with primary tumor entity, histopathological subtype, radiological features, adjuvant therapy and degree of surgical resection as assessed by an early post-operative MRI < 72h after surgery.

Results: From the two hundred thirteen patients evaluated, 106 were females. Median age was 63 years. Mean preoperative Karnofsky score was 90%. Most common primary tumors were non-small cell lung cancer (43.2%), melanoma (11.7%), gastrointestinal (11.7%), breast cancer (10.3%). From the histopathological point of view, most patients suffered from adenocarcinoma (68.5%), followed by malignant melanoma (11.7%), small-cell carcinoma (7.5%). A total of 51 (23.9%) patients developed a local recurrence. Univariate analysis showed, that detection of residual tumor in early postoperative MRI (<72hr) was the only risk factor for development of a local in-brain progression (2=19.4739>crit=5.991; p<0.05; Chi Square). In contrast, primary tumor, histological type, type of resection, dural involvement, cystic tumor or location were not significant factors for a local in-brain recurrence. Mean local progression free-survival was 9 months (0-74m). Mean follow-up was 12-months.

Conclusion: Our study indicates that detection of residual tumor in an early postoperative MRI < 72h was the only significant risk factor for local in-brain progression of cerebral metastases. Therefore, postoperative MRI < 72h might identify patients at risk for a local in-brain progression and enable a specific therapy of the tumor rest. Further studies are needed in order to evaluate the oncological impact.