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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Overall survival of patients suffering from 1-4 cerebral metastases and a surgical treatment in phase III studies

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  • Marcel Alexander Kamp - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Jasmin Weber - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Igor Fischer - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Jan Frederick Cornelius - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Marion Rapp - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Hans-Jakob Steiger - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Michael Sabel - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocP076

doi: 10.3205/18dgnc417, urn:nbn:de:0183-18dgnc4174

Published: June 18, 2018

© 2018 Kamp 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: Cerebral metastases are the most common intracerebral neoplasms. Since the Patchell study in 1990, complete surgical resection of single cerebral metastases is still a standard therapy. In the last years, introduction of new therapeutic strategies as target therapies were believed to significantly improve overall survival of oncologic patients. The present meta-analysis aimed to evaluate whether overall survival (OAS) in randomized controlled trails (RCT) significantly improved since the 1990s.

Methods: A systematic search of the PubMed database was performed to identify all RCT that reported an overall survival in patients with 1-4 cerebral metastases. Treatment strategy and OAS were extracted and related to the publication date.

Results: Totally, 9 RCT matching the inclusion criteria with a total of 987 patients were identified. 607 were randomized for a surgical treatment without or combined with an adjuvant treatment protocol. Among those patients, median OAS was 10.7 month (range 5.6 – 16 month). 2/9 studies revealed a significant improved OAS of a metastasectomy in combination with a whole brain radiation therapy (WBRT) as compared to WBRT alone. All other studies found no influence of randomization on the OAS. Linear regression analysis revealed a significantly improved OAS of patients with 1-4 cerebral metastases in the last 27 years (p =0.024).

Conclusion: RCT reveal a significant improved OAS of a surgical therapy as compared to WBRT alone. OAS of patients with 1-4 brain metastases significantly improved in the last 27 years. The improved OAS might be related to an improved systemic therapy as the majority of studies found no influence of the compared treatment protocols on the OAS.