title: Early postoperative magnet resonance tomography after resection of cerebral metastases.
abstract: BACKGROUND
  In contrast to malignant gliomas, the impact of an early postoperative MRI after surgery of cerebral metastasis is still unclear. The present study analyses early MRI-based postoperative resection controls and incidence of in-brain progression in 116 patients suffering from 130 cerebral metastases.
  
  
  METHODS
  The extent of surgical resection was verified by an early postoperative contrast-enhanced 1.5-T MRI within 72 h after surgery of cerebral metastases and correlated with in-brain progression, leptomeningeal carcinomatosis, and progression-free survival.
  
  
  RESULTS
  MRI confirmed complete resection was seen in 80 out of 130 metastases (61.5 %). In 24 metastases (18.5 %), no final decision on degree of resection could be made. Residual tumor was seen in 26 cases (20 %). Local in-brain progression was observed in 40 of 130 (30.8 %) cases. The incidence of in-brain progression significantly correlated with dural contact of the metastasis (p < 0.05) and residual tumor on early postoperative MRI (p < 0.0001). The odds ratio for local recurrence with residual tumor is 8.2-fold compared to no residual tumor.
  
  
  CONCLUSIONS
  Residual tumor after metastasis extirpation was shown in nearly 20 % of patients by an early postoperative MRI and significantly correlated with local in-brain progression. Furthermore, dural contact of cerebral metastases was identified as a risk factor for local recurrence. Further studies are mandatory to clearly identify the incidence of incomplete resections of cerebral metastases and their oncologic impact. An early postoperative MRI after resection of cerebral metastases is recommended as residual tumor promotes local recurrence.
authors.affiliation: Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Moorenstraße 5, Düsseldorf, Germany, marcelalexander.kamp@med.uni-duesseldorf.de.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Kamp
authors.forename: Marion
authors.initials: M
authors.lastname: Rapp
authors.forename: Julia
authors.initials: J
authors.lastname: Bühner
authors.forename: Philipp J
authors.initials: PJ
authors.lastname: Slotty
authors.forename: Dorothea
authors.initials: D
authors.lastname: Reichelt
authors.forename: Hosai
authors.initials: H
authors.lastname: Sadat
authors.forename: Maxine
authors.initials: M
authors.lastname: Dibué-Adjei
authors.forename: Hans-Jakob
authors.initials: HJ
authors.lastname: Steiger
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
authors.forename: Michael
authors.initials: M
authors.lastname: Sabel
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D019635:Neurosurgical Procedures / Q000009:adverse effects*