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复发性颅转移瘤开颅术后的结果。

Outcome after craniotomy for recurrent cranial metastases.

作者信息

Kennion Oliver, Holliman Damian

机构信息

a School of Medical Education, Newcastle University , Newcastle Upon Tyne , UK.

b Department of Neurosurgery , Royal Victoria Infirmary , Newcastle Upon Tyne , UK.

出版信息

Br J Neurosurg. 2017 Jun;31(3):369-373. doi: 10.1080/02688697.2017.1302072. Epub 2017 Mar 14.

Abstract

OBJECTIVE

To investigate the outcomes of patients with recurrent/progressive cranial metastases who underwent re-do craniotomy and to assess the utility of surgery as a treatment option.

METHODS

A retrospective study was conducted assessing survival after re-do craniotomy for recurrent or progressive cranial metastases. 29 patients were identified between January 2006 and December 2013. Data was gathered from a prospective pathology database, patients' notes and electronic records. The diagnosis of cranial metastasis was obtained through pathological analysis at the time of tumour resection. Results were analysed with Cox regression tests and converted into a Kaplan-Meier curve.

RESULTS

Median patient age was 57 years old (range 24-74 years) at diagnosis of brain metastases. Two patients had serious complications after re-do surgery. Five patients had >2 craniotomies for recurrent disease. Median survival after the first craniotomy was 18 months (range 4.1-50.9 months). Median survival after re-do craniotomy was 7.6 months (range 0.2-31.3 months). 90% of patients survived at least 3 months after re-do surgery, 65.5% survived at least 6 months.

CONCLUSION

This study suggests that re-do surgery is a viable treatment option for patients with recurrent cranial metastases.

摘要

目的

研究接受再次开颅手术的复发性/进行性颅转移瘤患者的治疗结果,并评估手术作为一种治疗选择的效用。

方法

进行一项回顾性研究,评估复发性或进行性颅转移瘤再次开颅手术后的生存率。2006年1月至2013年12月期间共确定了29例患者。数据收集自前瞻性病理数据库、患者病历和电子记录。颅转移瘤的诊断通过肿瘤切除时的病理分析获得。结果采用Cox回归检验进行分析,并转化为Kaplan-Meier曲线。

结果

脑转移瘤诊断时患者的中位年龄为57岁(范围24 - 74岁)。2例患者再次手术后出现严重并发症。5例患者因复发性疾病接受了>2次开颅手术。首次开颅手术后的中位生存期为18个月(范围4.1 - 50.9个月)。再次开颅手术后的中位生存期为7.6个月(范围0.2 - 31.3个月)。90%的患者再次手术后至少存活3个月,65.5%的患者至少存活6个月。

结论

本研究表明,再次手术是复发性颅转移瘤患者的一种可行治疗选择。

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