[Cerebral metastases. A study of a surgical series of 81 cases].
In this retrospective study, 81 patients operated by craniotomy for a brain metastasis are reviewed. Mean age is 56.3 years and most of the patients are male (71.6%). Clinically, 79% of the patients present a focal semiology, most frequently with neuropsychologic disturbances (43%); epilepsy is found in 31% of the cases. Symptoms related to intracranial hypertension (vomiting and headache) are present in 43% of the patients. On C.T.-scan, there is a solitary metastasis in 89% and the most common intracranial location is the frontal lobe (33.3%). The most frequent primary neoplasms are: bronchial adenocarcinoma in 19%, squamous carcinoma of the lung in 11%, melanoma in 12% and unknown origin in 18%. The surgical removal (as judged by the surgeon) is total in 70%, subtotal in 19% and partial in 11%. Standard operative mortality (30 days after craniotomy) is 7.4%. The postoperative course (till the patients leave our department) is excellent in 58% (complete neurologic recovery), steady in 20% (stability of symptoms and neurologic examination) and bad in 22%, with worsening of the neurological deficits. Most of the patients (84% of the patients who survive more than 30 days after the craniotomy) had postoperative whole brain radiotherapy with a hypofractionned schedule (total doses of 15 to 40 Gy with fractions of 200 to 650 cGy). Ten patients had surgery alone. Mean survival is 10.2 months with a follow-up of 12 months to 10 years. Ten patients survived over 18 months and one is still alive almost 4 years after his craniotomy. In this study, the survival is not modified by the primary lesion's histology.(ABSTRACT TRUNCATED AT 250 WORDS)
Delarive
J
J
Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
de Tribolet
N
N
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D004828:Epilepsies, Partial / Q000209:etiology; D005260:Female; D005625:Frontal Lobe; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D011879:Radiotherapy Dosage; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
Métastases cérébrales. Etude d'un collectif chirurgical de 81 cas.