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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

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Survival of patients undergoing resection of multiple lesions vs. one lesion in the presence of multiple metastases – a survival analysis based on the prospective Metasys-trial-data

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  • Christina Wolfert - Abteilung für Neurochirurgie, Göttingen, Deutschland
  • Abdelhalim Hussein - Abteilung für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
  • Ingo Fiss - Abteilung für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
  • Silvia Hernandez Duran - Abteilung für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
  • Annalen Bleckmann - Universitätsmedizin Göttingen, Abteilung für Onkologie, Göttingen, Deutschland
  • Veit Rohde - Abteilung für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen, Deutschland
  • Bawarjan Schatlo - Abteilung für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen, 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. DocP 044

doi: 10.3205/17dgnc607, urn:nbn:de:0183-17dgnc6075

Published: June 9, 2017

© 2017 Wolfert 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: Resection of multiple brain metastases is indicated under certain conditions. However, there are no data available from large-scale prospective studies if the resection of multiple metastases may not rather be detrimental in the presence of disseminated disease.

Methods: We included consecutive cases who underwent surgical resection of brain metastases at our institution since June 2013 up until 11/2015 in the present analysis. A minimum follow-up of 1 year and two or more metastatic lesions visible on MRI were required for inclusion in this study. We compared whether survival is different if more than one metastasis is resected. Survival analysis was based on Kaplan Meier log rank testing.

Results: Out of 147 cases included in the prospective Metastasys protocol, 65 fulfilled the inclusion criteria for the present analysis (49% female, mean age 63yrs (CI95%: 45-80yrs)). We dichtomized patients with multiple metastases as follows: In the single resection group (44/65 cases (68%)), and in the multiple resection group (21/65 cases (32%)). Metastases originated from a non small-cell lung cancer in 27%. Median overall survival was 4.5 (3.4-5.8) months in the single resection group and 5.4 (4.1-6.7) months in the multiple resection group. Kaplan-Meier Log rank testing revealed no difference between both groups (p=0.64).

Conclusion: We could not demonstrate a significant difference in survival between both groups. The generalizability of this finding is limited due to the individually-based decision process and the heterogenous underlying pathologies. The strength of the analysis is the prospective data collection, which was lacking in previous trials.