Abstract
Background: The benefits associated to the surgical treatment of brain metastases (BMs) in elderly patients has been extensively debated due to their higher biological fragility, but we still miss a “threshold.” The aim of this study is to evaluate their outcomes by a systematic comparison with a cohort of the youngest patients of our series of BMs. Methods: The surgical, radiologic, and oncologic outcomes of patients suffering from BM have been retrospectively reviewed for the present study. The patients have been subsequently assigned, according to their age in 2 groups: group A (<45 years old) and group B (>70 years old). Patient, surgery, and lesion-related data were recorded to identify the relationships with the following outcome variables: postoperative Karnofsky performance status, complications, and accessibility to adjuvant treatment. Results: The final cohort consisted of 309 patients, 201 men (65.2%) and 108 women (34.8%); average age was 39.1 ± 3.4 years for group A and 74.8 ± 2.9 years for group B. Expected survival was 6.15 ± 2.18 months for group A and 5.01 ± 2.43 months for group B. The statistical analysis disclosed no significant difference between the 2 groups, in term of postoperative Karnofsky performance status and the incidence of complications. Important, the accessibility to adjuvant treatment was not different between the 2 groups. Conclusions: The surgical treatment of BM in the septuagenarian patients is safe and effective. It increases the chances of long-term survival by preserving the functional and neurological status and leaving intact the accessibility to adjuvant treatments, similarly to what happens in the younger patients.
| Original language | English |
|---|---|
| Pages (from-to) | e565-e572 |
| Journal | World Neurosurgery |
| Volume | 114 |
| DOIs | |
| Publication status | Published - Jun 1 2018 |
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Keywords
- Adjuvant treatments
- Brain metastases
- Elderly
- KPS
- Surgery
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
Surgical Treatment of the Septuagenarian Patients Suffering From Brain Metastases : A Large Retrospective Observational Analytic Cohort-Comparison Study. / Frati, Alessandro; Pesce, Alessandro; Palmieri, Mauro; Celniku, Megi; Raco, Antonino; Salvati, Maurizio.
In: World Neurosurgery, Vol. 114, 01.06.2018, p. e565-e572.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical Treatment of the Septuagenarian Patients Suffering From Brain Metastases
T2 - A Large Retrospective Observational Analytic Cohort-Comparison Study
AU - Frati, Alessandro
AU - Pesce, Alessandro
AU - Palmieri, Mauro
AU - Celniku, Megi
AU - Raco, Antonino
AU - Salvati, Maurizio
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: The benefits associated to the surgical treatment of brain metastases (BMs) in elderly patients has been extensively debated due to their higher biological fragility, but we still miss a “threshold.” The aim of this study is to evaluate their outcomes by a systematic comparison with a cohort of the youngest patients of our series of BMs. Methods: The surgical, radiologic, and oncologic outcomes of patients suffering from BM have been retrospectively reviewed for the present study. The patients have been subsequently assigned, according to their age in 2 groups: group A (<45 years old) and group B (>70 years old). Patient, surgery, and lesion-related data were recorded to identify the relationships with the following outcome variables: postoperative Karnofsky performance status, complications, and accessibility to adjuvant treatment. Results: The final cohort consisted of 309 patients, 201 men (65.2%) and 108 women (34.8%); average age was 39.1 ± 3.4 years for group A and 74.8 ± 2.9 years for group B. Expected survival was 6.15 ± 2.18 months for group A and 5.01 ± 2.43 months for group B. The statistical analysis disclosed no significant difference between the 2 groups, in term of postoperative Karnofsky performance status and the incidence of complications. Important, the accessibility to adjuvant treatment was not different between the 2 groups. Conclusions: The surgical treatment of BM in the septuagenarian patients is safe and effective. It increases the chances of long-term survival by preserving the functional and neurological status and leaving intact the accessibility to adjuvant treatments, similarly to what happens in the younger patients.
AB - Background: The benefits associated to the surgical treatment of brain metastases (BMs) in elderly patients has been extensively debated due to their higher biological fragility, but we still miss a “threshold.” The aim of this study is to evaluate their outcomes by a systematic comparison with a cohort of the youngest patients of our series of BMs. Methods: The surgical, radiologic, and oncologic outcomes of patients suffering from BM have been retrospectively reviewed for the present study. The patients have been subsequently assigned, according to their age in 2 groups: group A (<45 years old) and group B (>70 years old). Patient, surgery, and lesion-related data were recorded to identify the relationships with the following outcome variables: postoperative Karnofsky performance status, complications, and accessibility to adjuvant treatment. Results: The final cohort consisted of 309 patients, 201 men (65.2%) and 108 women (34.8%); average age was 39.1 ± 3.4 years for group A and 74.8 ± 2.9 years for group B. Expected survival was 6.15 ± 2.18 months for group A and 5.01 ± 2.43 months for group B. The statistical analysis disclosed no significant difference between the 2 groups, in term of postoperative Karnofsky performance status and the incidence of complications. Important, the accessibility to adjuvant treatment was not different between the 2 groups. Conclusions: The surgical treatment of BM in the septuagenarian patients is safe and effective. It increases the chances of long-term survival by preserving the functional and neurological status and leaving intact the accessibility to adjuvant treatments, similarly to what happens in the younger patients.
KW - Adjuvant treatments
KW - Brain metastases
KW - Elderly
KW - KPS
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85046818925&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046818925&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2018.03.034
DO - 10.1016/j.wneu.2018.03.034
M3 - Article
C2 - 29548964
AN - SCOPUS:85046818925
VL - 114
SP - e565-e572
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -