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Multicenter Study
. 2024 Jul 26;47(1):354.
doi: 10.1007/s10143-024-02578-8.

Multiple craniotomies in patients with brain metastases: a two-center, propensity score-matched study

Luis Padevit  1 , Anna Maria Zeitlberger  2 , Nicolai Maldaner  1 , Johannes Sarnthein  1 , Oliver Bozinov  2 , Luca Regli  1 , Marian Christoph Neidert  2 , Carlo Serra  1 , Stefanos Voglis  3
Affiliations
Multicenter Study

Multiple craniotomies in patients with brain metastases: a two-center, propensity score-matched study

Luis Padevit et al. Neurosurg Rev. .

Abstract

The current study addresses the question of whether the resection of more than one BM by multiple craniotomies within the same operation is associated with more adverse events (AEs) and worse functional outcome compared to cases in which only one BM was resected. All patients who underwent more than one craniotomy for resection of multiple BM at two Swiss tertiary neurosurgical care centers were included. Any AEs, functional outcome, and overall survival (OS) were analyzed after 1:1 propensity score matching with patients who underwent removal of a single BM only. A total of 94 patients were included in the final study cohort (47 of whom underwent multiple craniotomies). There was no significant difference in the incidence of AEs between the single and the multiple craniotomy group (n = 2 (4.3%) vs. n = 4 (8.5%), p = .7). Change in modified Rankin Scale (mRS) and Karnofsky Performance Status (KPS) at discharge demonstrated that slightly more single craniotomy patients improved in mRS, while the proportion of patients who worsened in mRS (16.3 vs. 16.7%) and KPS (13.6 vs. 15.2%) was similar in both groups (p = .42 for mRS and p = .92 for KPS). Survival analysis showed no significant differences in OS between patients with single and multiple craniotomies (p = .18). Resection of multiple BM with more than one craniotomy may be considered a safe option without increased AEs or worse functional outcome.

Keywords: Adverse events; Brain metastases; Complications; Immunotherapy; Surgical resection; Targeted therapy.

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Conflict of interest statement

The authors declare no competing interests.

There is no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Clinical outcomes at discharge. (A & B) Percentages of mRS scores at admission (upper row) and discharge (lower row) for patients with single craniotomy (A) and for patients with multiple craniotomies (B). Changes of mRS (C) and KPS (D) at discharge relative to admission stratified for multiple craniotomies. mRS Modified Rankin Scale; KPS Karnofsky Performance Status
Fig. 2
Fig. 2
Overall survival stratified by multiple craniotomies
Fig. 3
Fig. 3
Overall survival stratified by multiple craniotomies and number of metastases for patients with multiple BMs
See this image and copyright information in PMC

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