The impact of urgent neurosurgery on the survival of cancer patients
Carregando...
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
SCIENTIFIC SCHOLAR
Citação
SURGICAL NEUROLOGY INTERNATIONAL, v.11, article ID 258, p, 2020
Resumo
Background: Patients with cancer are subject to all neurosurgical procedures of the general population, even if they are not directly caused by the tumor or its metastases. We sought to evaluate the impact of urgent neurosurgery on the survival of patients with cancer. Methods: We included patients submitted to neurosurgeries not directly related to their tumors in a cancer center from 2009 to 2018. Primary endpoints were mortality in index hospitalization and overall survival. Results: We included 410 patients, 144 went through elective procedures, functional (26.4%) and debridement (73.6%) and 276 urgent neurosurgeries were performed: one hundred and sixty-three ventricular shunts (59%), and 113 intracranial hemorrhages (41%). Median age was 56 (IQR = 24), 142 (51.4%) of patients were metastatic, with 101 (36.6%) having brain metastasis. In 82 (33.7%) of the urgent surgeries, the patient died in the same admission. Urgent surgeries were associated with mortality in index hospitalization (OR 3.45, 95% CI 1.93–6.15), as well as non-primary brain tumors (OR 3.13, 95% CI 1.48–6.61). Median survival after urgent surgeries was 102 days, compared to 245 days in the control group (Log rank, P < 0.01). Lower survival probability was associated with metastasis (HR 1.75, 95%CI 1.15–2.66) and urgent surgeries (HR 1.49, 95% CI 1.18–1.89). Within the urgent surgeries alone, metastasis predicted lower survival probability (HR 1.75, 95% CI 1.15–2.67). Conclusion: Conditions that require urgent neurosurgery in patients with cancer have a very poor prognosis. We present concrete data on the magnitude of several factors that need to be taken into account when deciding whether or not to recommend surgery. ©2020 Published by Scientific Scholar on behalf of Surgical Neurology International
Palavras-chave
Brain neoplasms, Neoplasm metastasis, Neurosurgery, Survival analysis
Referências
- Achrol, AS, Rennert, RC, Anders, C, Soffietti, R, Ahluwalia, MS, Nayak, L, Brain metastases (2019) Nat Rev Dis Primers, 5, p. 5
- Aguilar, MI, Freeman, WD., Spontaneous intracerebral hemorrhage (2010) Semin Neurol, 30, pp. 555-564
- Barbera, L, Paszat, L, Chartier, C., Indicators of poor quality end-of-life cancer care in Ontario (2006) J Palliat Care, 22, pp. 12-17
- Barbera, L, Taylor, C, Dudgeon, D., Why do patients with cancer visit the emergency department near the end of life? (2010) Can Med Assoc J, 182, pp. 563-568
- Bitoh, S, Hasegawa, H, Ohtsuki, H, Obashi, J, Fujiwara, M, Sakurai, M., Cerebral neoplasms initially presenting with massive intracerebral hemorrhage (1984) Surg Neurol, 22, pp. 57-62
- Bosscher, MR, Van Leeuwen, BL, Hoekstra, HJ., Current management of surgical oncologic emergencies (2015) PLoS One, 10, p. e0124641
- Caine, GJ, Stonelake, PS, Lip, GY, Kehoe, ST., The hypercoagulable state of malignancy: Pathogenesis and current debate (2002) Neoplasia, 4, pp. 465-473
- Fernández-García, MÁ, Cantarín-Extremera, V, Andión-Catalán, M, Duat-Rodríguez, A, Jiménez-Echevarría, S, Bermejo-Arnedo, I, Secondary intracranial hypertension in pediatric patients with leukemia (2017) Pediatr Neurol, 77, pp. 48-53
- Hemphill, JC, Greenberg, SM, Anderson, CS, Becker, K, Bendok, BR, Cushman, M, Guidelines for the management of spontaneous intracerebral hemorrhage: A guideline for healthcare professionals from the American heart association/ American stroke association (2015) Stroke, 46, pp. 2032-2060
- Kase, CS., Intracerebral hemorrhage: Non-hypertensive causes (1986) Stroke, 17, pp. 590-595
- Khorchid, YM, Malkoff, M., Intracranial hemorrhage focused on cancer and hemato-oncologic patients (2019) Oncologic Critical Care, pp. 1-14. , Cham: Springer International Publishing
- Kondziolka, D, Bernstein, M, Resch, L, Tator, CH, Fleming, JF, Vanderlinden, RG, Significance of hemorrhage into brain tumors: Clinicopathological study (1987) J Neurosurg, 67, pp. 852-857
- Kyrnetskiy, EE, Kun, LE, Boop, FA, Sanford, RA, Khan, RB., Types, causes, and outcome of intracranial hemorrhage in children with cancer (2005) J Neurosurg, 102, pp. 31-35
- Licata, B, Turazzi, S., Bleeding cerebral neoplasms with symptomatic hematoma (2003) J Neurosurg Sci, 47, pp. 201-210
- Little, JR, Dial, B, Bélanger, G, Carpenter, S., Brain hemorrhage from intracranial tumor (1979) Stroke, 10, pp. 283-288
- Mazerand, E, Gallet, C, Pallud, J, Menei, P, Bernard, F., Acute intracranial hypertension management in metastatic brain tumor: A French national survey (2019) Neurochirurgie, 65, pp. 348-356
- McArdle, CS, Hole, DJ., Emergency presentation of colorectal cancer is associated with poor 5-year survival (2004) Br J Surg, 91, pp. 605-609
- Navi, BB, Reichman, JS, Berlin, D, Reiner, AS, Panageas, KS, Segal, AZ, Intracerebral and subarachnoid hemorrhage in patients with cancer (2010) Neurology, 74, pp. 494-501
- Porta, M, Fernandez, E, Belloc, J, Malats, N, Gallén, M, Alonso, J., Emergency admission for cancer: A matter of survival? (1998) Br J Cancer, 77, pp. 477-484
- Rogers, LR., Cerebrovascular complications in cancer patients (2003) Neurol Clin, 21, pp. 167-192
- Schrader, B, Barth, H, Lang, EW, Buhl, R, Hugo, HH, Biederer, J, Spontaneous intracranial haematomas caused by neoplasms (2000) Acta Neurochir (Wien), 142, pp. 979-985
- Schwarzbach, CJ, Schaefer, A, Ebert, A, Held, V, Bolognese, M, Kablau, M, Stroke and cancer: The importance of cancer-associated hypercoagulation as a possible stroke etiology (2012) Stroke, 43, pp. 3029-3034
- Van Asch, CJ, Luitse, MJ, Rinkel, GJ, Van Der Tweel, I, Algra, A, Klijn, CJ., Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: A systematic review and meta-analysis (2010) Lancet Neurol, 9, pp. 167-176
- Vandyk, AD, Harrison, MB, Macartney, G, Ross-White, A, Stacey, D., Emergency department visits for symptoms experienced by oncology patients: A systematic review (2012) Support Care Cancer, 20, pp. 1589-1599
Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/12
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/62
Carregar mais Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/12
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/62