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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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Stereotactic biopsy in old and very old patients

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  • Johanna Quick - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Sae-Yeon Won - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Nazife Dinc - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Bedjan Behmanesh - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Volker Seifert - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, Deutschland
  • Gerhard Marquardt - Neurochirurgie, Goethe Universität Frankfurt, Frankfurt, 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 104

doi: 10.3205/17dgnc667, urn:nbn:de:0183-17dgnc6675

Published: June 9, 2017

© 2017 Quick 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

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Objective: Stereotactic biopsy is an everyday procedure among various neurosurgical departments. The procedure is performed to obtain tumor tissue of unknown origin. Going in hand with low complication rates and high diagnostic yield, stereotactic biopsies can be performed in adults and children, too, for lesions particularly in eloquent localizations. In this study we focused on old (80-84 years) and very old patients (85 years and above) in order to evaluate whether stereotactic biopsy should be performed and leads to further therapy. We also assessed complication rates of the procedure.

Methods: We performed a retrospective analysis of our database and included all patients over 80 years who underwent stereotactic biopsy at our department from October 2005 until May 2016. 47 Patients were included in this study. These patients were divided into two subgroups: group one from 80- 84 and group two 85 years and above. All patients underwent stereotactic biopsy to establish histopathological diagnosis. We excluded patients who underwent cyst puncture or puncture of hemorrhage because the procedure was not performed for diagnostic purposes. We assessed gender, neuroradiological diagnosis, Karnofsky performance score, number of tissue samples taken, histopathological diagnosis, localization, postoperative hemorrhage, modality of anesthesia, anticoagulation, and further therapy

Results: We included 34 patients in group one (age 80-84), they showed a median KPS of 80, and a median of 14 tissue samples was taken. In group two (age 85-88) 13 patients were included. A median number of 15 tissue samples were taken, median KPS was 70. 67.7% of the patients of group 1 wanted postoperative therapy (Radiation: 44.1%, Chemotherapy 11.8%, Radiochemotherapy 11.8%). In group 2, 53.3% of the patients wanted further therapy (Radiation: 15.4%, Radiochemotherapy: 23%, Chemotherapy 7.7%, Resection: 7.7%).

Conclusion: Stereotactic biopsy of intracerebral lesions leads to final histopathological diagnoses in 100% of the cases. The procedure is of low risk and, thus, should not be withhold aged patients since the majority of the elderly actively wishes further treatment.