Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume.

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Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume.

World Neurosurg. 2017 Mar 27;:

Authors: de Lima Oliveira M, Picarelli H, Menezes MR, Amorim R, Teixeira MJ, Bor-Seng-Shu E

Abstract
BACKGROUND: The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patients' quality of life.
OBJECTIVE: The aim of this study was to analyse the effect of conventional surgery supported by intra-operative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined Karnofsky post-operative scores (KPS) and tumor resection grades.
METHODS: Patients with a CM diagnosis were included in this study. Surgical treatment was either supported or not by IOUS. Pre- and post-operative KPS was determined by oncology team and cerebral tumor volume was estimated through pre- and post-operative MRI; surgical team determined whether it was possible to perform a total CM resection.
RESULTS: 78 patients were treated using surgical management (35 with and 43 without IOUS); in IOUS group post-operative KPS was higher (80 versus 70, p=0.045) and KPS evolution was superior (p=0.036), especially in the following CM subgroups: a difficulty of tumor resection ranking score<4 (p=0.037), tumor in an eloquent area (p=0.043), tumor not associated with vessels or nerves (p=0.007), and solitary lesions (p=0.038). The residual tumor volume was lower in the IOUS group (9.5% and 1.6 mm3 versus 30.8% and 9 mm3, p=0.05). In patients with a KPS≥70, the residual tumor volume was categorized as <10% or ≥10%, and 62% of patients had <10% residual tumors (76% in the IOUS group and 45% in the non-IOUS group; p=0.032 and OR=3.8).
CONCLUSION: IOUS may improve post-operative KPS and in decreasing residual tumor volumes in CM surgeries.

PMID: 28359927 [PubMed - as supplied by publisher]

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