title: Clinical outcomes from maximum-safe resection of primary and metastatic brain tumors using awake craniotomy.
abstract: OBJECTIVE
  To retrospectively analyze outcomes in patients undergoing awake craniotomies for tumor resection at our institution in terms of extent of resection, functional preservation and length of hospital stay.
  
  
  METHODS
  All cases of adults undergoing awake-craniotomy from September 2012-February 2015 were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications was extracted.
  
  
  RESULTS
  76 patient charts were analyzed. Resected cancer types included metastasis to the brain (41%), glioblastoma (34%), WHO grade III anaplastic astrocytoma (18%), WHO grade II glioma (4%), WHO grade I glioma (1%), and meningioma (1%). Over a half of procedures were performed in the frontal lobes, followed by temporal, and occipital locations. The most common indication was for motor cortex and primary somatosensory area lesions followed by speech. Extent of resection was gross total for 59% patients, near-gross total for 34%, and subtotal for 7%. Average hospital stay for the cohort was 1.7days with 75% of patients staying at the hospital for only 24h or less post surgery. In the postoperative period, 67% of patients experienced improvement in neurological status, 21% of patients experienced no change, 7% experienced transient neurological deficits, which resolved within two months post op, 1% experienced transient speech deficit, and 3% experienced permanent weakness.
  
  
  CONCLUSIONS
  In a consecutive series of 76 patients undergoing maximum-safe resection for primary and metastatic brain tumors, awake-craniotomy was associated with a short hospital stay and low postoperative complications rate.
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Departments of Neuro-Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Groshev
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Anesthesia, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Devang
authors.initials: D
authors.lastname: Padalia
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Anesthesia, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Sephalie
authors.initials: S
authors.lastname: Patel
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Anesthesia, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Garcia-Getting
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Departments of Neuro-Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Solmaz
authors.initials: S
authors.lastname: Sahebjam
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Departments of Neuro-Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Forsyth
authors.affiliation: Florida Atlantic University Charles Schmidt College of Medicine, 71-777 Glades Road, Boca Raton, FL 33431, USA.
authors.forename: Frank D
authors.initials: FD
authors.lastname: Vrionis
authors.affiliation: University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA; Departments of Neuro-Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA. Electronic address: arnold.etame@moffitt.org.
authors.forename: Arnold B
authors.initials: AB
authors.lastname: Etame
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology / Q000601:surgery; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D005909:Glioblastoma / Q000601:surgery; D005910:Glioma / Q000473:pathology / Q000556:secondary / Q000601:surgery; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D016896:Treatment Outcome; D014851:Wakefulness
keywords: Awake craniotomy; Brain tumor; Glioma; Metastases; Outcomes; Resection