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- Title
Analysis of prognostic factors and the role of epilepsy in neurosurgical patients with brain metastases.
- Authors
Ottaviani, Matteo Maria; Fasinella, Maria Rossella; Di Rienzo, Alessandro; Gladi, Maurizio; di Somma, Lucia Giovanna Maria; Iacoangeli, Maurizio; Dobran, Mauro
- Abstract
Background: Brain metastases (BMs) represent the most frequent brain tumors in adults. The identification of key prognostic factors is essential for choosing the therapeutic strategy tailored to each patient. Epilepsy can precede several months of other clinical presentations of BMs. This work aimed to study the impact of epilepsy and other prognostic factors on BMs patients' survival. Methods: This retrospective study included 51 patients diagnosed with BMs and who underwent neurosurgery between 2010 and 2021. The impact of BM features and patient's clinical characteristics on the overall survival (OS) was analyzed through uni- and multivariate analysis. Results: The average OS was 25.98 months and differed according to the histology of the primary tumor. The primary tumor localization and the presence of extracranial metastases had a statistically significant impact on the OS, and patients with single BM showed a superior OS to those with multifocal lesions. The localization of BMs in the temporal lobe correlated with the highest OS. The OS was significantly higher in patients who presented seizures in their clinical onset and in those who had better post-surgical Karnofsky performance status, no post-surgical complications, and who underwent post-surgical treatment. Conclusion: Our study has highlighted prognostically favorable patient and tumor factors. Among those, a clinical onset with epileptic seizures can help identify brain metastasis hitherto silent. This could lead to immediate diagnostic-therapeutic interventions with more aggressive therapies after appropriate multidisciplinary evaluation.
- Subjects
KARNOFSKY Performance Status; SURGICAL complications; BRAIN metastasis; PROGNOSIS; OVERALL survival; BRAIN tumors
- Publication
Surgical Neurology International, 2024, Vol 15, p1
- ISSN
2229-5097
- Publication type
Article
- DOI
10.25259/SNI_735_2023