title: Are melanomas averse to cerebellum? Cerebellar metastases in a surgical series.
abstract: OBJECTIVE
  To study the propensity of different cancers to metastasize to the cerebrum and cerebellum, and to study overall survival (OS) and prognostic factors for patients after surgical resection for cerebellar metastases.
  
  
  METHODS
  From a prospectively collected tumor database, all patients that underwent a craniotomy for intracranial metastases between 2003 and 2011 at Oslo University Hospital were included.
  
  
  RESULTS
  One hundred and forty patients underwent resection for cerebellar metastases. Most common primary tumor sites were lung, colon/rectum, and breast in 45%, 19%, and 14%, respectively. None were prostate cancers. Melanoma metastases were significantly underrepresented, and colorectal cancer metastases significantly overrepresented in cerebellum, compared to the overall proportion of cerebellar/supratentorial metastases surgically resected (P < 0.05). Thirty-day post-operative mortality rate was 4.3%. Median OS was 7.7 months (95% CI 6.0-9.5 months) irrespective of post-operative adjuvant therapy. Median OS was 51.8, 8.4, and 3.4 months, respectively, for recursive partitioning analysis class 1(n = 11), 2 (n = 78) and 3 (n = 34). Significant negative prognostic factors were age ≥65 years, Karnofsky performance score (KPS) <70, extracranial metastases and uncontrolled systemic disease.
  
  
  CONCLUSIONS
  Melanoma metastases were significantly underrepresented in cerebellum, whereas colorectal cancer metastases were significantly overrepresented. Surgical mortality and OS after surgical treatment of cerebellar metastases were similar to the results of supratentorial metastases.
authors: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
authors: S G
authors: SG
authors: Rogne
authors: E
authors: E
authors: Helseth
authors: P
authors: P
authors: Brandal
authors: D
authors: D
authors: Scheie
authors: T R
authors: TR
authors: Meling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D003399:Craniotomy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
keywords: brain metastases; brain tumor surgery; cerebellar metastases; colorectal cancer; malignant melanoma