Академический Документы
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metastases
Brain metastases (BM) - incidence
• Burden brain metastasis is
significant
• Literature
• 8.3-14.3 / 100.000 inhabitants
• 8.5 – 9.6% of all cancer patients
develop BM
• 85% cerebral
• 10-15% cerebellar
• 1-3% brainstem
In our department prevalence of BM was of…
*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 Jan;96(1):33-43
BM – Indications for surgery
• Size: tumor > 3cm
• Location: all BM except basal ganglia, thalamus or brainstem
• Clinical status: good clinical outcome with prolonged postoperative
survival if clinical status >70 KPS
• Number – still a controversy
• Past: no more than 1
• Now: As many as technically feasible, as long as there are no additional risks
regarding postoperative newly induced morbidity
BM – Surgery aims
• Aim of surgery:
• Complete surgical resection
• Low morbidity
• Sustained local tumor control
• In order to achieve the surgical aims we need:
Adjuncts to surgery
• Neuronavigation
• Functional MRI – eloquent area surgery
Surgical approach