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Surgical management of lateral-ventricle metastases: report of 29 cases in a single-institution experience Hassaneen W; Suki D; Salaskar AL; Wildrick DM; Lang FF; Fuller GN; Sawaya RJ Neurosurg 2010[May]; 112 (5): 1046-55OBJECT: The aim of this study was to review the outcome of patients undergoing surgery for treatment of lateral-ventricle metastases. METHODS: Imaging information and chart reviews of operative reports were used to conduct a retrospective analysis in 29 patients who underwent resection of lateral-ventricle metastases at the authors' institution between 1993 and 2007. Clinical and neurosurgical outcomes and recurrence rates were studied. RESULTS: The mean patient age was 56 years (range 20-69 years); 66% of patients were male. Single intraventricular metastases occurred in 69% of patients, and 55% of them had systemic metastases. The 30-day postoperative mortality rate was 7%. There was intracerebral tumor recurrence in 41% of patients, with 1 patient undergoing a second operation for this. The median postoperative survival duration for 28 patients (excluding 1 patient with preoperative leptomeningeal disease) was 11.7 months; the 3- and 5-year survival rates were 17 and 11%, respectively. Univariate analysis identified factors significantly influencing survival, including the preoperative Karnofsky Performance Scale (KPS) score (p = 0.02), the number of cerebral metastases (p = 0.02), the presence of primary renal cell carcinoma (RCC) (p = 0.02), and the resection method (en bloc vs piecemeal; p = 0.05). The presence of extracranial metastases did not significantly influence survival. Multivariate analysis showed that the preoperative KPS score (p = 0.002), the presence of primary RCC (p = 0.039), and the resection method (en bloc vs piecemeal; p = 0.008) correlated significantly with survival time. CONCLUSIONS: Surgery is an important component in the management of intraventricular metastases. To the authors' knowledge, this is the first study focusing totally on resection of lateral-ventricle metastases. The authors found that patients with primary RCC, those with a favorable preoperative KPS score, and those who underwent en bloc resection had a better outcome than others.|Adult[MESH]|Aged[MESH]|Cerebral Ventricle Neoplasms/mortality/*secondary/surgery[MESH]|Cerebral Ventricles/*pathology/surgery[MESH]|Female[MESH]|Humans[MESH]|Magnetic Resonance Imaging[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Recurrence, Local[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Young Adult[MESH] |
