Survival and recurrence for patients undergoing surgery of skull base intracranial metastases

Kaisorn L. Chaichana, Mariana Flores, Shami Acharya, Paul Sampognaro, Chetan Bettegowda, Daniele Rigamonti, Jon D. Weingart, Alessandro Olivi, Gary L. Gallia, Henry Brem, Michael Lim, Alfredo Quinones-Hinojosa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective Skull base metastases (SBMs) are rare lesions in close proximity to critical neural and vasculature structures. This rarity and complexity have led many to only offer nonsurgical therapies. The surgical outcomes for patients with SBM therefore remain unknown. Design Retrospective, comparison analyses. Setting Johns Hopkins Hospital. Participants All patients who underwent intracranial metastatic tumor surgery. Main Outcome Measure Survival and recurrence. Results Of the 708 patients who underwent intracranial metastatic tumor surgery, 29 (4%) had SBM: 3 (10%) involved the anterior skull base, 7 (24%) the sella, 6 (21%) the orbit, 2 (7%) the sphenoid wing, 3 (10%) the clivus, 4 (14%) the petrous bone, and 4 (14%) the paranasal sinuses. Following surgery, 6 (50%) had improvements in vision and 14 (88%) had improvement and/or maintenance of their cranial nerve symptoms. Three (10%), 0(0%), and 1(3%) developed a new motor, language, and vision deficit, respectively. There were no differences in median survival (10.0 versus 9.2 months, p = 0.48) and local progression-free survival (PFS) (p = 0.52), but there was improved distal PFS (p = 0.04) between patients with and without SBM. Conclusions Patients with SBM are relatively rare. These patients can tolerate surgery with minimal morbidity and mortality, and they have similar prognoses to patients without SBM.

Original languageEnglish (US)
Pages (from-to)228-235
Number of pages8
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume74
Issue number4
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Skull Base
Neoplasm Metastasis
Recurrence
Survival
Disease-Free Survival
Petrous Bone
Posterior Cranial Fossa
Cranial Nerves
Paranasal Sinuses
Orbit
Neoplasms
Language
Maintenance
Outcome Assessment (Health Care)
Morbidity
Mortality

Keywords

  • metastatic brain tumor
  • recurrence
  • skull base
  • surgery
  • survival

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Survival and recurrence for patients undergoing surgery of skull base intracranial metastases. / Chaichana, Kaisorn L.; Flores, Mariana; Acharya, Shami; Sampognaro, Paul; Bettegowda, Chetan; Rigamonti, Daniele; Weingart, Jon D.; Olivi, Alessandro; Gallia, Gary L.; Brem, Henry; Lim, Michael; Quinones-Hinojosa, Alfredo.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 74, No. 4, 2013, p. 228-235.

Research output: Contribution to journalArticle

Chaichana, KL, Flores, M, Acharya, S, Sampognaro, P, Bettegowda, C, Rigamonti, D, Weingart, JD, Olivi, A, Gallia, GL, Brem, H, Lim, M & Quinones-Hinojosa, A 2013, 'Survival and recurrence for patients undergoing surgery of skull base intracranial metastases', Journal of Neurological Surgery, Part B: Skull Base, vol. 74, no. 4, pp. 228-235. https://doi.org/10.1055/s-0033-1342925
Chaichana, Kaisorn L. ; Flores, Mariana ; Acharya, Shami ; Sampognaro, Paul ; Bettegowda, Chetan ; Rigamonti, Daniele ; Weingart, Jon D. ; Olivi, Alessandro ; Gallia, Gary L. ; Brem, Henry ; Lim, Michael ; Quinones-Hinojosa, Alfredo. / Survival and recurrence for patients undergoing surgery of skull base intracranial metastases. In: Journal of Neurological Surgery, Part B: Skull Base. 2013 ; Vol. 74, No. 4. pp. 228-235.
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abstract = "Objective Skull base metastases (SBMs) are rare lesions in close proximity to critical neural and vasculature structures. This rarity and complexity have led many to only offer nonsurgical therapies. The surgical outcomes for patients with SBM therefore remain unknown. Design Retrospective, comparison analyses. Setting Johns Hopkins Hospital. Participants All patients who underwent intracranial metastatic tumor surgery. Main Outcome Measure Survival and recurrence. Results Of the 708 patients who underwent intracranial metastatic tumor surgery, 29 (4{\%}) had SBM: 3 (10{\%}) involved the anterior skull base, 7 (24{\%}) the sella, 6 (21{\%}) the orbit, 2 (7{\%}) the sphenoid wing, 3 (10{\%}) the clivus, 4 (14{\%}) the petrous bone, and 4 (14{\%}) the paranasal sinuses. Following surgery, 6 (50{\%}) had improvements in vision and 14 (88{\%}) had improvement and/or maintenance of their cranial nerve symptoms. Three (10{\%}), 0(0{\%}), and 1(3{\%}) developed a new motor, language, and vision deficit, respectively. There were no differences in median survival (10.0 versus 9.2 months, p = 0.48) and local progression-free survival (PFS) (p = 0.52), but there was improved distal PFS (p = 0.04) between patients with and without SBM. Conclusions Patients with SBM are relatively rare. These patients can tolerate surgery with minimal morbidity and mortality, and they have similar prognoses to patients without SBM.",
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AU - Chaichana, Kaisorn L.

AU - Flores, Mariana

AU - Acharya, Shami

AU - Sampognaro, Paul

AU - Bettegowda, Chetan

AU - Rigamonti, Daniele

AU - Weingart, Jon D.

AU - Olivi, Alessandro

AU - Gallia, Gary L.

AU - Brem, Henry

AU - Lim, Michael

AU - Quinones-Hinojosa, Alfredo

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N2 - Objective Skull base metastases (SBMs) are rare lesions in close proximity to critical neural and vasculature structures. This rarity and complexity have led many to only offer nonsurgical therapies. The surgical outcomes for patients with SBM therefore remain unknown. Design Retrospective, comparison analyses. Setting Johns Hopkins Hospital. Participants All patients who underwent intracranial metastatic tumor surgery. Main Outcome Measure Survival and recurrence. Results Of the 708 patients who underwent intracranial metastatic tumor surgery, 29 (4%) had SBM: 3 (10%) involved the anterior skull base, 7 (24%) the sella, 6 (21%) the orbit, 2 (7%) the sphenoid wing, 3 (10%) the clivus, 4 (14%) the petrous bone, and 4 (14%) the paranasal sinuses. Following surgery, 6 (50%) had improvements in vision and 14 (88%) had improvement and/or maintenance of their cranial nerve symptoms. Three (10%), 0(0%), and 1(3%) developed a new motor, language, and vision deficit, respectively. There were no differences in median survival (10.0 versus 9.2 months, p = 0.48) and local progression-free survival (PFS) (p = 0.52), but there was improved distal PFS (p = 0.04) between patients with and without SBM. Conclusions Patients with SBM are relatively rare. These patients can tolerate surgery with minimal morbidity and mortality, and they have similar prognoses to patients without SBM.

AB - Objective Skull base metastases (SBMs) are rare lesions in close proximity to critical neural and vasculature structures. This rarity and complexity have led many to only offer nonsurgical therapies. The surgical outcomes for patients with SBM therefore remain unknown. Design Retrospective, comparison analyses. Setting Johns Hopkins Hospital. Participants All patients who underwent intracranial metastatic tumor surgery. Main Outcome Measure Survival and recurrence. Results Of the 708 patients who underwent intracranial metastatic tumor surgery, 29 (4%) had SBM: 3 (10%) involved the anterior skull base, 7 (24%) the sella, 6 (21%) the orbit, 2 (7%) the sphenoid wing, 3 (10%) the clivus, 4 (14%) the petrous bone, and 4 (14%) the paranasal sinuses. Following surgery, 6 (50%) had improvements in vision and 14 (88%) had improvement and/or maintenance of their cranial nerve symptoms. Three (10%), 0(0%), and 1(3%) developed a new motor, language, and vision deficit, respectively. There were no differences in median survival (10.0 versus 9.2 months, p = 0.48) and local progression-free survival (PFS) (p = 0.52), but there was improved distal PFS (p = 0.04) between patients with and without SBM. Conclusions Patients with SBM are relatively rare. These patients can tolerate surgery with minimal morbidity and mortality, and they have similar prognoses to patients without SBM.

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