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KMID : 0942820110100020091
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Journal of Korean Brain Tumor Society
2011 Volume.10 No. 2 p.91 ~ p.96
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Postoperative Recurrence and Growth Rate of Cystic Brain Metastases
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Choi Hyun-Ho
Shin Sang-Hoon
Gwak Ho-Shin
Lee Seung-Hoon
Yoo Heon
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Abstract
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Objectives: The purpose of this study is to evaluate local recurrence rate after surgery for cystic brain metastasis and determine its growth rate.
Methods: Between June 2002 and February 2009, 38 patients underwent surgery for cystic brain metastasis at our institution. The median follow up period was 257 days (mean 393, range 67-1,509) after surgery. If the tumors were large and comprised of single cysts (≥3 cm in the largest diameter), surrounded by a relatively small amount of enhancing peripheral tissue, the tumors were classified into the large cystic group. The largest diameter was measured on T1-gadolinium enhanced Magnetic resonance images and cystic volume was measured by by using V-works software. The sizes of cystic mass were measured on serial MRIs to evaluate growth rate. Growth rate was calculated as the increased volumes divided by the followed period. The primary end point of this analysis was local recurrence of metastatic brain tumors.
Result:Among 38 patients, 18 (47.4%) patients experienced local recurrence. Among them, twelve patients in the large cystic brain metastasis group (66.7%) had a local recurrence, while 6 (30%) in the small cystic brain metastasis group.(p=0.024). The 6 months recurrence free survival (RFS) rate was 44.4% in the large cystic group, and 60% in the small cystic group. Cox regression analysis hazard ratio of the large cystic mass compared to the small cystic mass for local recurrence was 2.61. The growth rate of cystic metastasis was 86.42 mm3/day in nine patients with cystic brain metastasis.
Conclusion: The results showed that large cystic brain metastasis frequently recurred after surgery regardless of the use of adjuvant therapy. Therefore, careful and close follow-up is necessary in patients with large cystic brain metastasis.
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KEYWORD
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Brain metastasis, Surgery, Local recurrence, Cyst, Growth rate
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