Minimally invasive resection of brain metastases. (12th October 2019)

• Record Type: Journal Article
• Authors: Phang, Isaac; Leach, John; Leggate, James; Karabatsou, Konstatina; Coope, David; D'Urso, Pietro
• Is Part Of: Neuro-oncology. Volume 21(2019)Supplement 4
• Page Start: iv5
• Page End: iv5
• Publication Date: 2019-10-12
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noz167.021
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Minimally invasive resection of brain metastases aims to maximize resection while minimizing brain trauma. Patients with one or more metastases resection following neuro-oncology multidisciplinary meeting discussion from Sep 2014 to Oct 2018 with pre- and post-operative MRI were included. All patients including posterior fossa metastases or multiple metastases were positioned supine. Hair was not shaved. Volumetric post-contrast T1 MRI was used for incision planning and neuronavigation. The craniotomy site was tailored to tumor depth according to keyhole principles and ranged between 2 to 3cm. Intraoperative monitoring and awake mapping were carried out in selected cases. Out of 320 consecutive patients with brain metastases, 44 patients were identified as suitable for minimally invasive resection. 9 had no post-operative imaging and were excluded. There were 39 metastases in 35 patients. There were 18 cerebellar metastases, 9 frontal, 5 parietal, 3 occipital, 2 temporal, 1 intraventricular and 1 basal ganglia. Median length of stay was days (range: 1 – 24). Average tumor volume was 54.7cm 3 (range: 10 – 240cm 3 ). Endoscopic assistance was used in 4 patients. Median performance status improved from 2 to 1(range: pre-operative: 0 – 4; post-operative: 0 – 2). Median survival was 14.7 months. Minimally invasive resection of brain metastasis is safe and effective and in selected cases confers advantages compared to standard techniques.