학술논문
Surgical treatment of brain metastases: Review of 124 patients
이용수 3
- 영문명
- 발행기관
- 대한두개저학회
- 저자명
- 이상복(Sang-Bok Lee) 이정일(Jung-Il Lee)
- 간행물 정보
- 『대한두개저학회지』제10권 제1호, 24~33쪽, 전체 10쪽
- 주제분류
- 의약학 > 일반외과학
- 파일형태
- 발행일자
- 2015.05.30
4,000원
구매일시로부터 72시간 이내에 다운로드 가능합니다.
이 학술논문 정보는 (주)교보문고와 각 발행기관 사이에 저작물 이용 계약이 체결된 것으로, 교보문고를 통해 제공되고 있습니다.
국문 초록
영문 초록
Objective This study was performed to assess the outcomes and prognostic factors in the patientswith brain metastases who underwent surgery as the primary treatment. Materials and Methods Between January 1998 and June 2008, 124 patients were surgically treated for newly diagnosed brain metastases. Surgery was recommended as an initial treatment for the patients with Karnofsky performance scale(KPS) score not less than 60 and single accessible lesion or multiple lesions including at least one largesymptomatic lesion of superficial location. We assessed preoperative status, postoperative neurological outcomes, complications and survival through retrospective review of medical record and radiological data. Results Eighty five patients presented with single lesion and 39 patients with multiple lesions. Lung was the most common site of primary tumor(55, 44%) followed by breast (8, 6%), genitouninary(GU) system(renal, ovary and prostate) (21, 17%), gastrointestinal(GI) system(stomach, pancreas, rectal) (16, 13%), others(17, 14%), unknown primaries(7, 6%), and so on. Postoperatively, whole brain radiotherapy(WBRT) was performed in 112 patients(90%) and radiosurgery in 28 patients(23%). Compared with preoperative state, 103 patients(83%) showed improved neurological state during immediate postoperative period. Postoperative morbidity and mortality related to surgery developed in 15 patients (13.2%) and 2(0.9%) respectively. Overall median survival time was 34 weeks(range, 1- 380). Patients with single cerebral metastasis had a median survival time(MST) of 35weeks(range 1 380), whereas patients with multiple lesions had a MST of 33 weeks (range 2-131) showing no statistical difference between two groups(p = 0.13). Recursive partitioning analysis(RPA) class and status of extra-cerebral tumor were significant prognostic factors identified through univariate and multivariate analysis. Median survival of RPA class I patients was 53 weeks(range 2 380) significantly longer than 30 weeks(range 1 - 321) of RPA II or III patients(p = 0.001). Local recurrence of surgically treated lesions developed in 15 patients whereas recurrence at remote site from the operated lesion developed in 17 patients(14%) during the follow up period. So, local recurrence rate was 12% and 24% at 6 and 12 months after operation. Conclusion This analysis essentially confirms that surgical resection of symptomatic metastatic lesions relieve neurological symptoms rapidly with acceptable risk. Local control rate is seemingly better than that without surgery when compared with the data from the literature. The RPA class or extracranial disease activity are important prognostic factors of survival. Surgical excision of only symptomatic lesions followed by WBRT and radiosurgery resulted in median survival not worse than that of the patients with single lesion removed completely. Operative treatment of metastatic brain lesions should be tailored according to the clinical situation and traditional guide for surgical treatment needs to be refined.
목차
Clinical material and methods
Results
Discussion
Conclusion
해당간행물 수록 논문
- 뇌하수체선종에 대한 미세현미경 경접형동 수술과 내시경 경접형동 수술의 비교
- 이비인후과 영역에서의 3차원 입체 영상 연구의 유용성
- 유양돌기절제술 후 발생한 무증상의 뇌수막류 1례
- 중년 남성에서 발생한 다형성 성상 세포종
- 베게너 육아종증으로 인해 발생한 양측 안면 신경마비 1례
- 삼출성 중이염 유사증상으로 발현한 중이 수막종 1례
- Surgical treatment of brain metastases: Review of 124 patients
- Various Surgical Techniques of Facial Reanimation for Chronic Facial Paralysis
참고문헌
관련논문
의약학 > 일반외과학분야 NEW
- It was ‘up to code’ - but rules predate the age of advanced technology: it was suitable then but not now
- Burning measure for burning mouth syndrome: a systematic review
- Jaws of knowledge: an analysis of temporomandibular joint insights in dental training—a quasi-experiment study
최근 이용한 논문
교보eBook 첫 방문을 환영 합니다!
신규가입 혜택 지급이 완료 되었습니다.
바로 사용 가능한 교보e캐시 1,000원 (유효기간 7일)
지금 바로 교보eBook의 다양한 콘텐츠를 이용해 보세요!