Artikel
Early postoperative magnet-resonance tomography after resection of cerebral metastases
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Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: In contrast to malignant gliomas, the impact of an early postoperative MRI after surgery of cerebral metastasis is still unclear. The present study analyses early MRI-based postoperative resection controls and incidence of in-brain-progression in 116 patients suffering from overall 130 cerebral metastases.
Method: Extent of surgical resection was verified by an early postoperative contrast-enhanced 1,5T-MRI within 72 hours after surgery and correlated with in-brain-progression, leptomeningeal carcinomatosis and progression free survival.
Results: MRI confirmed complete resection was seen in 80 / 130 metastases (61.5). In 24 metastases (18.5%) no final decision on degree of resection could be made. Residual tumour was seen in 26 cases (20 %). Local in-brain-progression was observed in 40 / 130 (30.8%) cases. The incidence of in-brain progression significantly correlated with dural contact of the metastasis (p < .05) and residual tumour on early postoperative MRI (p < .0001). The odd's ratio for local recurrence with residual tumor is 8.2 fold compared to no residual tumor on postoperative MRI.
Conclusions: Residual tumour after metastasis extirpation was shown in nearly 20 % of patients by an early postoperative MRI and significantly correlated with local in-brain-progression. Furthermore, dural contact of cerebral metastases was identified as risk factor for local recurrence. Further studies are mandatory to clearly identify the incidence of incomplete resections of cerebral metastases and their oncologic impact. An early postoperative MRI after resection of cerebral metastases is recommended as residual tumor promotes local recurrence.