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KMID : 0942820080070010016
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Journal of Korean Brain Tumor Society
2008 Volume.7 No. 1 p.16 ~ p.25
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The Efficacy of Wide Surgical Resection of Brain Metastasis With Intraoperative Margin Biopsy
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Kim Young-Zoon
Yoo Heon
Yang Hee-Seok
Shin Sang-Hoon
An Sung-Yul
Jung Eu-gene
Hong Seung-Koan
Lee Seung-Hoon
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Abstract
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Background: The influence on therapeutic outcome of the wide surgical resection of brain metastasis(BM) including tumor cells microscopically infiltrating adjacent brain parenchyma with confirming clean surgical margin by intraoperative margin biopsy is not known. This study was carried out to clarify the therapeutic impact of such resections.
Materials and Methods: From June 2002 to April 2005, 90 patients(66 males and 24 females；mean age：56.7 years) underwent surgical resection for BM. We undertook microscopic complete resection, including microscopic infiltrative tumor cells adjacent brain parenchyma, with confirming a pathologically clean surgical margin during surgery for the BMs located in a non-eloquent area in 47 patients(Group A), but in 43 patients, we undertook gross complete resection without removal of neighboring brain parenchyma due to their eloquent location(Group B). The two groups were then compared in terms of survival, and local and distant recurrence.
Results: Mean follow-up duration was 18.6 month and 71 patients(78.9%) died during follow-up. Median survival times were 13.1 months in group A and 12.1 months in group B(p=0.309). One-year and 2-year local recurrence rates were 21.2% and 25.8% in group A, and 65.2% and 65.2% in group B, respectively(p=0.000). One-year and 2-year distant recurrence rates were 46.3% and 57.2% in group A, and 33.2% and 33.2% in group B, respectively(p=0.140).
Conclusion: These results suggest that the wide surgical resection of BM including tumor cells infiltrating adjacent brain parenchyma with confirming clean surgical margin renders better local control.
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KEYWORD
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Microscopic complete resection, Brain metastasis, Local control, Survival, Surgical resection, Marg in biopsy
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