Henderson Duncan, Zafar Arif, Bjornson Anna, Razak Adam, Achawal Shailendra, Danciut Mihai, Smith Aubrey, O'Reilly Gerry, Rajaraman Chittoor, Bahl Anuj
Department of Neurosurgery, Hull Royal Infirmary, Yorkshire, United Kingdom.
Surg Neurol Int. 2022 May 27;13:219. doi: 10.25259/SNI_103_2022. eCollection 2022.
The aim of this study was to identify prognostic factors associated with resection of intracranial metastases.
A retrospective case series including patients who underwent resection of cranial metastases from March 2014 to April 2021 at a single center. This identified 112 patients who underwent 124 resections. The median age was 65 years old (24-84) and the most frequent primary cancers were nonsmall cell lung cancer (56%), breast adenocarcinoma (13%), melanoma (6%), and colorectal adenocarcinoma (6%). Postoperative MRI with contrast was performed within 48 hours in 56% of patients and radiation treatment was administered in 41%. GraphPad Prism 9.2.0 was used for the survival analysis.
At the time of data collection, 23% were still alive with a median follow-up of 1070 days (68-2484). The 30- and 90-day, and 1- and 5-year overall survival rates were 93%, 83%, 35%, and 17%, respectively. The most common causes of death within 90 days were as follows: unknown (32%), systemic or intracranial disease progression (26%), and pneumonia (21%). Age and extent of neurosurgical resection were associated with overall survival ( < 0.05). Patients aged >70 had a median survival of 5.4 months compared with 9.7, 11.4, and 11.4 for patients <50, 50-59, and 60-69, respectively. Gross-total resection achieved an overall survival of 11.8 months whereas sub-total, debulking, and unclear extent of resection led to a median survival of 5.7, 7.0, and 9.0 months, respectively.
Age and extent of resection are potential predictors of long-term survival.
本研究的目的是确定与颅内转移瘤切除术相关的预后因素。
一项回顾性病例系列研究，纳入了2014年3月至2021年4月在单一中心接受颅转移瘤切除术的患者。共确定了112例患者，进行了124次手术切除。中位年龄为65岁（24 - 84岁），最常见的原发癌是非小细胞肺癌（56%）、乳腺腺癌（13%）、黑色素瘤（6%）和结肠腺癌（6%）。56%的患者在术后48小时内进行了增强MRI检查，41%的患者接受了放射治疗。使用GraphPad Prism 9.2.0进行生存分析。
在数据收集时，23%的患者仍存活，中位随访时间为1070天（68 - 2484天）。30天、90天、1年和5年的总生存率分别为93%、83%、35%和17%。90天内最常见的死亡原因如下：不明原因（32%）、全身或颅内疾病进展（26%）和肺炎（21%）。年龄和神经外科手术切除范围与总生存相关（P < 0.05）。年龄>70岁的患者中位生存期为5.4个月，而年龄<50岁、50 - 59岁和60 - 69岁的患者分别为9.7个月、11.4个月和11.4个月。全切除患者的总生存期为11.8个月，而次全切除、减瘤切除和切除范围不明确的患者中位生存期分别为5.7个月、7.0个月和9.0个月。
年龄和切除范围是长期生存的潜在预测因素。
