Agnoletti Alessandro, Mencarani Camilla, Panciani Pier Paolo, Buffoni Lucio, Ronchetti Gabriele, Spena Giannantonio, Tartara Fulvio, Buglione Michela, Pagano Manuela, Ducati Alessandro, Fontanella Marco, Garbossa Diego
Department of Neuroscience, Division of Neurosurgery, University of Torino; Division of Neurosurgery, University of Brescia, Italy.
J Cancer Res Ther. 2014 Jan-Mar;10(1):79-83. doi: 10.4103/0973-1482.131390.
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.
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.
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.
脑转移瘤（MTS）的预后与全身和局部疾病的进展相关。MTS切除术的重要性已得到指出。非神经系统原因导致的高死亡率表明，现代治疗方法能够显著控制神经系统内的疾病。然而，多发性病变会增加治疗难度，在这些情况下，手术的作用仍有待明确。
我们收集了两个中心在8年期间对肺癌脑转移瘤患者进行手术的临床数据。手术患者的选择遵循明确标准；多发性MTS的上限为3个。我们分析了该队列患者的功能和生存结果。
我们的系列研究纳入了242例患者：其中105例有多发性MTS。统计分析显示，单发性和多发性病变患者的平均生存期和预后无显著差异。15.7%的病例因神经系统原因死亡。手术候选人的选择需要综合考虑多个因素，并影响该治疗的成功率。在符合选择标准的多发性病变患者中，我们观察到术后仍有令人满意的效果。我们的结果表明，手术也可应用于颅内疾病更为弥漫的部分选定患者。即使在多发性MTS的情况下，术前准确的患者选择与术后可接受的生活质量相关。
