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Factors Affecting Survival in Metastatic Tumor Treatment

Year 2020, Volume: 11 Issue: 1, 82 - 85, 03.03.2020

Abstract

Background: Brain metastatic tumors are an important complication in the general management of cancer, which often overshadows primary brain tumors. The incidence of brain metastases is increasing due to improvements in systemic therapy and MRI screening, but basic treatment methods are lacking.

Methods: The patients who were admitted to the hospital with the diagnosis of metastatic brain tumor, operated and followed up were included in our study.

Results: A total of 39 patients were included to the study. Total resection (TR) was performed in 22 patients (56.4%), subtotal resection (STR) in 14 patients (35.8%), and only biopsy was performed in 3 patients (7.6%) due to their poor condition. When Karnofsky Performance Status (KPS) of the patients were evaluated, KPS> 70 was found in 75% of the patients.

Conclusion: The patients should be treated with corticosteroids instead of continuing with emergency surgical resection, which provides sufficient time to complete preoperative preparations. The amount of resection of metastatic tumor is significantly related with the prognosis.

References

  • Lowery FJ, Yu D. Brain metastasis: unique challenges and open opportunities. Biochim Biophys Acta (BBA)-Reviews Cancer. 2017;1867(1):49–57.Brastianos PK, Carter SL, Santagata S, Cahill DP, Taylor-Weiner A, Jones RT, et al. Genomic characterization of brain metastases reveals branched evolution and potential therapeutic targets. Cancer Discov. 2015;5(11):1164–77.​Lah TT, Novak M, Breznik B. Brain Malignancies: Cancer Cell Trafficking in and out of the Niches. Semin Cancer Biol [Internet]. 2019; Available from: http://www.ncbi.nlm.nih.gov/pubmed/31654711Achrol AS, Rennert RC, Anders C, Soffietti R, Ahluwalia MS, Nayak L, et al. Brain metastases. Nat Rev Dis Prim. 2019;5(1):1–26.Owonikoko TK, Arbiser J, Zelnak A, Shu HKG, Shim H, Robin AM, et al. Current approaches to the treatment of metastatic brain tumours. Vol. 11, Nature Reviews Clinical Oncology. 2014. p. 203–22.Salehi A, Kamath AA, Leuthardt EC, Kim AH. Management of intracranial metastatic disease with laser interstitial thermal therapy. Front Oncol. 2018;8(OCT):1–6.Distefano A, Yap HY, Hortobagyi GN, Blumenschein GR. The natural history of breast cancer patients with brain metastases. Cancer. 1979;44(5):1913–8.Gavrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neurooncol. 2005;75(1):5–14.Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Curr Oncol Rep. 2012;14(1):48–54.Schellinger PD, Meinck HM, Thron A. Diagnostic accuracy of MRI compared to CCT in patients with brain metastases. J Neurooncol. 1999;44(3):275–81.Sze G, Milano E, Johnson C, Heier L. Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. Am J Neuroradiol. 1990;11(4):785–91.Davis FG, Dolecek TA, McCarthy BJ, Villano JL. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data. Neuro Oncol. 2012;14(9):1171–7.​Nussbaum ES, Djalilian HR, Cho KH, Hall WA. Brain metastases: histology, multiplicity, surgery, and survival. Cancer Interdiscip Int J Am Cancer Soc. 1996;78(8):1781–8.Zhang X, Zhang W, Cao W-D, Cheng G, Liu B, Cheng J. A review of current management of brain metastases. Ann Surg Oncol. 2012;19(3):1043–50.Sunderland GJ, Jenkinson MD, Zakaria R. Surgical management of posterior fossa metastases. J Neurooncol [Internet]. 2016;130(3):535–42. Available from: http://dx.doi.org/10.1007/s11060-016-2254-2​Kalkanis SN, Kondziolka D, Gaspar LE, Burri SH, Asher AL, Cobbs CS, et al. The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96(1):33–43.Vecht CJ, Haaxma‐Reiche H, Noordijk EM, Padberg GW, Voormolen JHC, Hoekstra FH, et al. Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery. Ann Neurol Off J Am Neurol Assoc Child Neurol Soc. 1993;33(6):583–90.Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. Jama. 2006;295(21):2483–91.Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494–500.​Mekhail T, Sombeck M, Sollaccio R. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. Curr Oncol Rep. 2011;13(4):255–8.Thon N, Kreth F-W, Tonn J-C. The role of surgery for brain metastases from solid tumors. In: Handbook of clinical neurology. Elsevier; 2018. p. 113–21.Lee C-H, Kim DG, Kim JW, Han JH, Kim YH, Park C-K, et al. The role of surgical resection in the management of brain metastasis: a 17-year longitudinal study. Acta Neurochir (Wien). 2013;155(3):389–97

Factors Affecting Survival in Metastatic Tumor Treatment

Year 2020, Volume: 11 Issue: 1, 82 - 85, 03.03.2020

Abstract

Amaç: Sistemik tedavi ve MR taramasındaki gelişmelernedeniyle beyin metastazlarının görülme sıklığı artmaktadırancak temel tedavi yöntemleri bulunmamaktadır.

Yöntem: Metastatik beyin tümörü tanısı ile hastaneye yatırılanhastalar ameliyat edildi ve takip edildi.

Bulgular: Çalışmaya toplam 39 hasta dahil edildi22 hastadatotal rezeksiyon (TR) (% 56,4), 14 hastada subtotal rezeksiyon(STR) (% 35,8), 3 hastada (% 7,6) kötü durum nedeniylesadece biyopsi yapıldıKarnofsky Performans Durumu (KPS) değerlendirildiğindehastaların % 75'inde KPS> 70 bulundu.

Sonuç: Hastalar preoperatif hazırlıkları tamamlamak içinyeterli zaman sağlayan acil cerrahi rezeksiyona devam etmekyerine kortikosteroidlerle tedavi edilmelidirMetastatiktümörün rezeksiyon miktarı prognoz ile anlamlı şekilde ilişkiliolduğu görüldü.

References

  • Lowery FJ, Yu D. Brain metastasis: unique challenges and open opportunities. Biochim Biophys Acta (BBA)-Reviews Cancer. 2017;1867(1):49–57.Brastianos PK, Carter SL, Santagata S, Cahill DP, Taylor-Weiner A, Jones RT, et al. Genomic characterization of brain metastases reveals branched evolution and potential therapeutic targets. Cancer Discov. 2015;5(11):1164–77.​Lah TT, Novak M, Breznik B. Brain Malignancies: Cancer Cell Trafficking in and out of the Niches. Semin Cancer Biol [Internet]. 2019; Available from: http://www.ncbi.nlm.nih.gov/pubmed/31654711Achrol AS, Rennert RC, Anders C, Soffietti R, Ahluwalia MS, Nayak L, et al. Brain metastases. Nat Rev Dis Prim. 2019;5(1):1–26.Owonikoko TK, Arbiser J, Zelnak A, Shu HKG, Shim H, Robin AM, et al. Current approaches to the treatment of metastatic brain tumours. Vol. 11, Nature Reviews Clinical Oncology. 2014. p. 203–22.Salehi A, Kamath AA, Leuthardt EC, Kim AH. Management of intracranial metastatic disease with laser interstitial thermal therapy. Front Oncol. 2018;8(OCT):1–6.Distefano A, Yap HY, Hortobagyi GN, Blumenschein GR. The natural history of breast cancer patients with brain metastases. Cancer. 1979;44(5):1913–8.Gavrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neurooncol. 2005;75(1):5–14.Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Curr Oncol Rep. 2012;14(1):48–54.Schellinger PD, Meinck HM, Thron A. Diagnostic accuracy of MRI compared to CCT in patients with brain metastases. J Neurooncol. 1999;44(3):275–81.Sze G, Milano E, Johnson C, Heier L. Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. Am J Neuroradiol. 1990;11(4):785–91.Davis FG, Dolecek TA, McCarthy BJ, Villano JL. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data. Neuro Oncol. 2012;14(9):1171–7.​Nussbaum ES, Djalilian HR, Cho KH, Hall WA. Brain metastases: histology, multiplicity, surgery, and survival. Cancer Interdiscip Int J Am Cancer Soc. 1996;78(8):1781–8.Zhang X, Zhang W, Cao W-D, Cheng G, Liu B, Cheng J. A review of current management of brain metastases. Ann Surg Oncol. 2012;19(3):1043–50.Sunderland GJ, Jenkinson MD, Zakaria R. Surgical management of posterior fossa metastases. J Neurooncol [Internet]. 2016;130(3):535–42. Available from: http://dx.doi.org/10.1007/s11060-016-2254-2​Kalkanis SN, Kondziolka D, Gaspar LE, Burri SH, Asher AL, Cobbs CS, et al. The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96(1):33–43.Vecht CJ, Haaxma‐Reiche H, Noordijk EM, Padberg GW, Voormolen JHC, Hoekstra FH, et al. Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery. Ann Neurol Off J Am Neurol Assoc Child Neurol Soc. 1993;33(6):583–90.Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. Jama. 2006;295(21):2483–91.Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494–500.​Mekhail T, Sombeck M, Sollaccio R. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. Curr Oncol Rep. 2011;13(4):255–8.Thon N, Kreth F-W, Tonn J-C. The role of surgery for brain metastases from solid tumors. In: Handbook of clinical neurology. Elsevier; 2018. p. 113–21.Lee C-H, Kim DG, Kim JW, Han JH, Kim YH, Park C-K, et al. The role of surgical resection in the management of brain metastasis: a 17-year longitudinal study. Acta Neurochir (Wien). 2013;155(3):389–97
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Kemal Ertilav 0000-0002-0520-0672

Serdar Ercan 0000-0002-8299-1789

Zeki Serdar Ataizi 0000-0001-5960-3082

Publication Date March 3, 2020
Submission Date November 21, 2019
Published in Issue Year 2020 Volume: 11 Issue: 1

Cite

Vancouver Ertilav K, Ercan S, Ataizi ZS. Factors Affecting Survival in Metastatic Tumor Treatment. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2020;11(1):82-5.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.