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 language | English |
---|---|
Article number | 1464 |
Journal | Medicina (Lithuania) |
Volume | 60 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2024 |
Externally published | Yes |
Keywords
- brain metastases
- neurosurgical resection
- older patients
- recurrent brain metastases
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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.
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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",
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}
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 journal › Article › peer-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