Clinical presentation, treatment and outcome of patients with cerebral metastases: the University of São Paulo series

Abstract

-Introduction: Secondary neoplasias are the most common tumors affecting the central nervous system and several clinical aspects of this disease are still controversial. Method: Forty-seven consecutive patients with the diagnosis of cerebral metastases (CM) were retrospectively studied at the Clinical Hospital of São Paulo University Medical School. Mean age was 53.9 years and 25 patients were female. Results: The most frequent primary sites were breast, lung and skin. Symptoms were related to increased intracranial pressure (ICP) in 48.9%, focal neurological events in 27.7% and both in 17.0%. Single brain metastases were found in 57.4% of those cases, the frontal lobe being most frequently affected. Surgical treatment was performed in 68.1%, radiotherapy in 40.4% and chemotherapy in 17.0%. Conclusion: After statistical analysis, there was a trend towards prolonged survival of female patients, patients with ICP symptoms and the surgical group. Data from different centers are essential to establish the best management of CM. KEY WORDS: CNS tumors, secondary neoplasias, cerebral metastases.Apresentação clínica, tratamento e desfecho de pacientes com metástases cerebrais: a experiência da Universidade de São Paulo RESUMO -Introdução: As neoplasias secundárias são o principal grupo de tumores que afetam o sistema nervoso central. Diversos aspectos da evolução e tratamento desta doença são controversos. Método: Quarenta e sete pacientes com metástase cerebral foram estudados retrospectivamente no Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo. A idade média foi 53,9 anos e 25 pacientes eram do sexo feminino. Resultados: Os sítios primários mais freqüentes foram mama, pulmão e pele. Os sintomas apresentados foram relacionados à hipertensão intracraniana (HIC) em 48,9%, sintomas focais em 27,7% e ambos em 17,0%. Metástases únicas foram encontradas em 57,8% dos casos. O tratamento foi cirurgia em 68,1% dos casos, radioterapia em 40,4% e quimioterapia em 17,0%. Conclusão: Após análise estatística, foram encontradas tendências a maior sobrevida nos pacientes do sexo feminino, no grupo de pacientes que apresentava sintomas de HIC e no grupo cirúrgico. Dados de diferentes centros são essenciais para o estabelecer a melhor forma de tratamento para as mestástases cerebrais. PALAVRAS-CHAVE: tumores SNC, metástases cerebrais, neoplasias secundárias.The most common group of neoplastic diseases affecting the central nervous system (CNS) is composed of secondary neoplasias, representing a significant cause of morbidity and mortality. The proportion of all cancer patients who develop cerebral metastases (CM) at some time during the course of their disease lies between 20 and 30% 1 . This frequency is further increased in patient series including only certain neoplastic diseases such as melanoma, lung and breast cancer or series which underwent magnetic resonnance to detect CM, reaching 50% in an autopsy series of patients with lung cancer [2][3][4][5] . Even though the skull and the meninges ma...

Faktor-Faktor Yang Berpengaruh Pada Prognosis Pasien Tumor Otak Metastasis Di Rsud Saiful Anwar Malang

“…Berbeda dengan keganasan sistemik, defisit neurologis tersebut tidak hanya dipengaruhi oleh derajat keganasan tumor, namun bervariasi tergantung lokasi dan ukuran tumor. [4][5][6] Pencitraan radiologis penting untuk mendeteksi tumor metastasis pada otak pada pasien dengan keganasan yang telah diketahui sebelumnya. Computed tomography (CT) dan Magnetic Resonance Imaging (MRI) adalah modalitas pencitraan utama yang digunakan dalam diagnosis tumor metastasis pada otak.…”

“…Menurut Andrade, dkk tidak ada hubungan signifikan antara lokasi dan jumlah lesi tumor otak metastase dengan survival pasien. [6] Rotta, dkk. yang menyatakan bahwa jumlah lesi secara stastistik tidak signifikan memengaruhi angka survival rate setelah pasien terdiagnosis tumor otak metastasis.…”

Central Nervous System Metastases in HER-2–Overexpressing Metastatic Breast Cancer: A Treatment Challenge

“…Common symptoms consist of headaches (24%-48%), focal neurological dysfunction (20%-40%), and nausea, vomiting, and seizures (10%-20%) [22,39,40].…”

Prognostic factors and outcome of surgically treated patients with brain metastases of non‐small cell lung cancer

“…Outcomes in patients with BM from NSCLC are very poor. Without treatment, patients can only survive approximately one month; two‐month survival can be achieved with the use of corticosteroids . Survival could be extended from three to six months with corticosteroids and whole brain radiation therapy (WBRT), and further extended from nine to 14 months with surgical resection and postoperative WBRT .…”