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Metastases to the cerebellum. Results and prognostic factors in a consecutive series of 44 operated patients

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Abstract

Background Recent reports on large number of patients with brain metastases report that Whole Brain Radiotherapy (WBRT) and Radiosurgery (RS) should be the treatments of choice, particularly in multiple lesions cases. Among the prognostic factors, the cerebellar location was never considered, although this results in hydrocephalus, brain stem compression, ataxia, intracranial hypertension. Materials and methods We evaluated 44 patients with cerebellar metastases operated over 6 years. Primary lesions were: Lung (15), Breast (12), Gastrointestinal (9), Gut (3), Ovary (2), Melanoma (1), Salivary gland carcinoma (1), Unknown (1). Lesions were <3 cm in 11 cases, ≥3 cm in 33. Average KPS scoring at admission was 69.9. Twenty nine scored ≥70, 15 < 70. Results Two patients died for surgical complications, 2 died within 1 months for other causes, 2 were lost to follow up. Eight had postoperative hematoma requiring reoperation, 1 had an occipital infarction. Average KPS scoring at discharge was 76.4, P < 0.002. Those patients that had complications scored less, the difference is significant (P < 0.008). Median survival was 8 months, 1 year survival rate 29.9%. Survival was correlated with either admission or discharge KPS (≥70 vs. <70): P = 0.05 and P = 0.0001 respectively. None of the other parameters considered reached statistical significance. Conclusions Open microneurosurgery is probably still the most effective therapy in improving survival and KPS in patients with large cerebellar metastases, given that the proper surgical technique is used and that complications do not occur. Specific data on cerebellar metastases as an independent subgroup are needed from radiosurgical series.

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Authors and Affiliations

  1. Division of Neurosurgery, “Regina Elena” National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy

    Alfredo Pompili, Carmine Maria Carapella, Fabio Cattani, Emanuele Occhipinti & Stefano Telera

  2. Division of Medical Oncology A, “Regina Elena” National Cancer Institute, Rome, Italy

    Alessandra Fabi

  3. Biostatistical Unit, “Regina Elena” National Cancer Institute, Rome, Italy

    Diana Giannarelli

  4. Service of Anesthesiology, “Regina Elena” National Cancer Institute, Rome, Italy

    Maddalena Giovannetti

  5. Division of Radiotherapy, “Regina Elena” National Cancer Institute, Rome, Italy

    Alessandra Mirri

  6. Service of Diagnostic Radiology and Imaging, “Regina Elena” National Cancer Institute, Rome, Italy

    Antonello Vidiri

  7. Service of Neurology, “Regina Elena” National Cancer Institute, Rome, Italy

    Andrea Pace

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  1. Alfredo Pompili
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  2. Carmine Maria Carapella
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  8. Emanuele Occhipinti
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  9. Stefano Telera
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  10. Antonello Vidiri
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  11. Andrea Pace
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Correspondence to Alfredo Pompili.

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Pompili, A., Carapella, C.M., Cattani, F. et al. Metastases to the cerebellum. Results and prognostic factors in a consecutive series of 44 operated patients. J Neurooncol 88, 331–337 (2008). https://doi.org/10.1007/s11060-008-9572-y

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  • DOI: https://doi.org/10.1007/s11060-008-9572-y

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