The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population (2024)

Abstract

Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.

Original languageEnglish
Article number1464
JournalMedicina (Lithuania)
Volume60
Issue number9
DOIs
StatePublished - Sep 2024
Externally publishedYes

Keywords

  • brain metastases
  • neurosurgical resection
  • older patients
  • recurrent brain metastases

Access to Document

Other files and links

Fingerprint

Dive into the research topics of 'The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population'. Together they form a unique fingerprint.

View full fingerprint

Cite this

  • APA
  • Author
  • BIBTEX
  • Harvard
  • Standard
  • RIS
  • Vancouver

Goldberg, M., Heinrich, V., Altawalbeh, G., Negwer, C., Wagner, A., Gempt, J., Meyer, B., & Aftahy, A. K. (2024). The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population. Medicina (Lithuania), 60(9), Article 1464. https://doi.org/10.3390/medicina60091464

Goldberg, Maria ; Heinrich, Valeri ; Altawalbeh, Ghaith et al. / The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population. In: Medicina (Lithuania). 2024 ; Vol. 60, No. 9.

@article{aedd916cedb74a9a9a3a910b58697bea,

title = "The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population",

abstract = "Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.",

keywords = "brain metastases, neurosurgical resection, older patients, recurrent brain metastases",

author = "Maria Goldberg and Valeri Heinrich and Ghaith Altawalbeh and Chiara Negwer and Arthur Wagner and Jens Gempt and Bernhard Meyer and Aftahy, {Amir Kaywan}",

note = "Publisher Copyright: {\textcopyright} 2024 by the authors.",

year = "2024",

month = sep,

doi = "10.3390/medicina60091464",

language = "English",

volume = "60",

journal = "Medicina (Lithuania)",

issn = "1010-660X",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "9",

}

Goldberg, M, Heinrich, V, Altawalbeh, G, Negwer, C, Wagner, A, Gempt, J, Meyer, B & Aftahy, AK 2024, 'The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population', Medicina (Lithuania), vol. 60, no. 9, 1464. https://doi.org/10.3390/medicina60091464

The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population. / Goldberg, Maria; Heinrich, Valeri; Altawalbeh, Ghaith et al.
In: Medicina (Lithuania), Vol. 60, No. 9, 1464, 09.2024.

Research output: Contribution to journalArticlepeer-review

TY - JOUR

T1 - The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population

AU - Goldberg, Maria

AU - Heinrich, Valeri

AU - Altawalbeh, Ghaith

AU - Negwer, Chiara

AU - Wagner, Arthur

AU - Gempt, Jens

AU - Meyer, Bernhard

AU - Aftahy, Amir Kaywan

N1 - Publisher Copyright:© 2024 by the authors.

PY - 2024/9

Y1 - 2024/9

N2 - Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.

AB - Background and Objectives: The impact of surgery for recurrent brain metastases in elderly patients has been the object of debate due to limited information in the literature. We analyzed clinical outcome and survival of elderly patients with recurrent brain metastases in order to assess potentially beneficial role of surgery. Materials and methods: In total, 219 patients with recurrent brain metastases between 2007 and 2022 were identified, of which 95 underwent re-resection; 83 patients aged 65 and older were analyzed. A survival analysis was performed, and clinical outcomes were evaluated. Results: The median survival time after surgery for recurrent brain metastases was 6 months (95CI 4–10) in older patients and 8 (95CI 7–9) in younger patients (p = 0.619). Out of all the older patients, 33 who underwent surgical resection showed prolonged survival compared with patients who did not receive surgical resection (median: 14, 95CI 8–19 vs. 4, 95CI 4–7, p = 0.011). All patients had preoperative Karnofsky performance scores of >70, which did not deteriorate after surgery (87.02 ± 5.76 vs. 85 ± 6.85; p = 0.055). In the univariate analysis, complete cytoreduction was a favorable prognostic factor. The tumor volume, the number of metastases, extracranial disease progression, adjuvant radiation, and systemic therapy did not affect survival in this cohort. Conclusions: Patients aged 65 and older benefit from neurosurgical resections of recurrent brain metastases. Survival did not differ from that in younger patients, which can be explained by a better preoperative functional status. Moreover, independent of the extent of resection, older patients who underwent surgery showed better survival than patients who did not receive surgical treatment. Complete cytoreduction was a favorable prognostic marker.

KW - brain metastases

KW - neurosurgical resection

KW - older patients

KW - recurrent brain metastases

UR - http://www.scopus.com/inward/record.url?scp=85205228558&partnerID=8YFLogxK

U2 - 10.3390/medicina60091464

DO - 10.3390/medicina60091464

M3 - Article

C2 - 39336505

AN - SCOPUS:85205228558

SN - 1010-660X

VL - 60

JO - Medicina (Lithuania)

JF - Medicina (Lithuania)

IS - 9

M1 - 1464

ER -

Goldberg M, Heinrich V, Altawalbeh G, Negwer C, Wagner A, Gempt J et al. The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population. Medicina (Lithuania). 2024 Sep;60(9):1464. doi: 10.3390/medicina60091464

The Role of Repeated Surgical Resections for Recurrent Brain Metastases in Older Population (2024)
Top Articles
Latest Posts
Recommended Articles
Article information

Author: Dong Thiel

Last Updated:

Views: 5903

Rating: 4.9 / 5 (59 voted)

Reviews: 82% of readers found this page helpful

Author information

Name: Dong Thiel

Birthday: 2001-07-14

Address: 2865 Kasha Unions, West Corrinne, AK 05708-1071

Phone: +3512198379449

Job: Design Planner

Hobby: Graffiti, Foreign language learning, Gambling, Metalworking, Rowing, Sculling, Sewing

Introduction: My name is Dong Thiel, I am a brainy, happy, tasty, lively, splendid, talented, cooperative person who loves writing and wants to share my knowledge and understanding with you.