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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 1  |  Page : 79-83

Surgery in cerebral metastases: Are numbers so important?


1 Department of Neuroscience, Division of Neurosurgery, University of Torino, Italy
2 Department of Neuroscience, Division of Neurosurgery, University of Torino; Division of Neurosurgery, University of Brescia, Italy
3 Department of Oncology, University of Torino, Italy
4 Division of Neurosurgery, University of Brescia, Italy
5 Department of Radiation Oncology, University of Brescia, Italy
6 Department of Oncology, Doctoral School in Biomedical Sciences and Oncology, University of Torino, Italy

Correspondence Address:
Pier Paolo Panciani
Department of Neuroscience, Division of Neurosurgery, University of Brescia, Italy. P.zza Spedali Civili, 1, 25123, Brescia
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.131390

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Background: The prognosis of cerebral metastases (MTS) is linked to progression of both systemic and local disease. The importance of MTS resection has been already pointed out. The observation of a high mortality for not-neurological causes confirms that the modern treatments allow a significant control of the disease within the nervous system. Nevertheless, management difficulties increase with multiple lesions and in these cases the role of surgery has still to be defined. Materials and Methods: We collected the clinical data of patients operated in two centers for cerebral MTS from lung carcinoma during 8 years. Patient selection for surgery followed definite criteria; the limit for multiple MTS was three. We analyzed the functional and survival outcomes of the cohort. Results and Conclusions: Our series included 242 patients: 105 had multiple MTS. Statistical analysis did not show significant differences in mean survival and outcomes between patients with single and multiple lesions. The decease occurred for neurological causes in 15.7% of cases. The selection of candidates for surgery requires several considerations and entails the success rate of this treatment. In patients with the multiple lesions who fulfilled the selection criteria we observed a nevertheless satisfying success after the operation. Our results imply that surgery may be applied also in selected patients with more diffuse intracranial disease. A pre-operative accurate patient selection is related to acceptable quality-of-life following the operation even in cases of multiple MTS.

Abstract in Chinese

脑转移瘤的手术治疗:转移灶数量很重要么? 背景:脑转移瘤(MTS)的预后与全身及局部疾病的发展相关。MTS手术切除的重要性已被指出。对非神经学原因引起的高死亡率的观察确定了现代医学治疗主要考虑神经系统疾病的有效控制。然而,具体处理上的困难因为多种损伤而增加,手术的地位仍需明确。 材料和方法:我们收集了2个中心8年来肺癌脑转移并接受手术的病人的临床资料。病例选择有明确标准:最少的MTS转移灶个数为3个。我们分析了这群人的功能恢复和生存结果。 结果和结论:总共242例病人:105例有多发MTS。统计学分析表明:单个和多个转移灶病人在平均生存时间和转归上没有明显差异。因神经源性原因引起的死亡占15.7%。 申请手术病例的选择要考虑多个因素,治疗的成功率是需要考虑的。在满足筛选标准的多发转移灶病例中,我们还是得到了令人满意的术后成功率。我们的结果意味着在颅内多发病灶的病人中手术也可以实施。多发脑转移瘤病人,只要术前严格选择,术后仍可有较好的生活质量。 关键词:大脑,肺癌,多发转移,手术,生存



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