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Early postoperative magnet resonance tomography after resection of cerebral metastases

  • Clinical Article - Brain Tumors
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

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.

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Conflict of interest

Prof. Sabel is a consultant for Johnson & Johnson Company and Integra Company. Maxine Dibué-Adjei is actually employed by Cyberonics Europe BVBA. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript

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Author notes

  1. Maxine Dibué-Adjei

    Present address: Cyberonics Europe BVBA, Airport Plaza, Kyoto Building, Leonardo da Vincilaan 19, 1831, Zaventem, Belgium

Authors and Affiliations

  1. Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Moorenstraße 5, Düsseldorf, Germany

    Marcel A. Kamp, Marion Rapp, Julia Bühner, Philipp J. Slotty, Hosai Sadat, Maxine Dibué-Adjei, Hans-Jakob Steiger & Michael Sabel

  2. Institute for Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Dorothea Reichelt & Bernd Turowski

  3. Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada

    Philipp J. Slotty

Authors
  1. Marcel A. Kamp
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  2. Marion Rapp
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Corresponding author

Correspondence to Marcel A. Kamp.

Additional information

Presentation at a conference

Annual meeting of the section “Neuro-oncology, Munic Neuro-week 2014, 17.09.2014”

“Early postoperative magnet-resonance tomography after resection of cerebral metastases”

M.A. Kamp, P.J. Slotty, D. Reichelt, H. Sadat, M. Rapp, M. Dibué, H.-J. Steiger, N. Turowski, M. Sabel

Marcel A. Kamp and Marion Rapp contributed equally to this work.

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Kamp, M.A., Rapp, M., Bühner, J. et al. Early postoperative magnet resonance tomography after resection of cerebral metastases. Acta Neurochir 157, 1573–1580 (2015). https://doi.org/10.1007/s00701-015-2479-4

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  • DOI: https://doi.org/10.1007/s00701-015-2479-4

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