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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Surgical treatment of geriatric patients with brain metastases

Operative Versorgung geriatrischer Patienten mit Hirnmetastasen

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  • presenting/speaker Muriel Heimann - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Matthias Schneider - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Niklas Schäfer - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Ulrich Herrlinger - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Parrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP148

doi: 10.3205/21dgnc433, urn:nbn:de:0183-21dgnc4331

Published: June 4, 2021

© 2021 Heimann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Due to the aging population and ongoing advances in cancer control, the pursuit of optimal management in geriatric patients with brain metastases is an increasing challenge, especially due to the scarce data available. We have therefore analyzed our institutional data with regard to factors influencing overall survival in geriatric patients with brain metastases.

Methods: Between 2013 and 2018, patients aged ≥ 65 years with surgically treated brain metastases were included in this retrospective analysis. In the search for preoperatively identifiable risk factors for poor overall survival (OS), in addition to the underlying cancer, the preoperative frailty of patients was analyzed using the modified Frailty Index (mFI).

Results: A total of 189 geriatric patients with surgically treated brain metastases were identified. Complete follow-up was available in 180 patients. Geriatric patients categorized as least-frail achieved a median OS of 18 months, while frailest patients achieved an OS of only 3 months (p<0.0001). Cox regression analysis detected “primary cancer site other than the breast” (p=0.028), “further intracranial metastases” (p=0.001), “infratentorial localization” (p=0.011), “preoperative CRP >5mg/dl” (p=0. 01) and “frail patients (mFI ≥ 0.27)” (p=0.003) as predictors for poor survival in geriatric patients undergoing surgical treatment for brain metastases.

Conclusion: In this study, preoperatively detectable conditions are presented that lead to poor survival in geriatric patients with brain metastases requiring surgery. Particularly noteworthy is the impact of frailty in geriatric patients with brain metastases. The results of this study are intended to contribute to better counselling/support of affected geriatric patients and their families.