Background/aim: The treatment of solitary brain metastasis is a challenging intervention since the incidence increases and prognosis is poor. This study investigated the role of perilesional edema in the overall mass effect of solitary brain metastasis. Patients and methods: We conducted a retrospective analysis on 88 patients with single supratentorial brain metastasis and concomitant perilesional edema undergoing en bloc resection. Each patient was evaluated for perilesional brain edema grading. We stratified patients into three groups based on the size of the metastatic lesion and the extent of perilesional edema. Results: The grade of perilesional edema at 30 days after surgical removal did not correlate with the maximum diameter of the metastasis (Pearson's correlation 0.098, p=0.494). In patients with a maximal metastatic diameter ≤2 cm, the grade of perilesional edema before surgical treatment was 1.63 (STD 0.43), while 30 days after removal it was significantly reduced; 0.47 (STD 0.26), p<0.001. Conclusion: The overall mass effect of solitary supratentorial brain metastases is not correlated to the size of the lesion and the grade of the associated perilesional edema should be considered. Surgical en bloc resection can be considered the first choice of treatment in the presence of solitary metastasis ≤2 cm in maximal diameter but with high-grade edema, since this treatment reduces the overall mass effect.

En bloc resection of solitary brain metastasis: the role of perilesional edema / Bruzzaniti, Placido; Lapolla, Pierfrancesco; D'Amico, Alessia; Zancana, Giuseppa; Katsev, Michael; Relucenti, Michela; Familiari, Giuseppe; Mingoli, Andrea; D'Andrea, Giancarlo; Frati, Alessandro; Salvati, Maurizio; Santoro, Antonio; Familiari, Pietro. - In: IN VIVO. - ISSN 0258-851X. - 36:3(2022), pp. 1274-1284. [10.21873/invivo.12827]

En bloc resection of solitary brain metastasis: the role of perilesional edema

Bruzzaniti, Placido
Primo
;
Lapolla, Pierfrancesco
Secondo
;
Zancana, Giuseppa;Katsev, Michael;Relucenti, Michela;Familiari, Giuseppe;Mingoli, Andrea;D'Andrea, Giancarlo;Frati, Alessandro;Santoro, Antonio
Penultimo
;
Familiari, Pietro
Ultimo
2022

Abstract

Background/aim: The treatment of solitary brain metastasis is a challenging intervention since the incidence increases and prognosis is poor. This study investigated the role of perilesional edema in the overall mass effect of solitary brain metastasis. Patients and methods: We conducted a retrospective analysis on 88 patients with single supratentorial brain metastasis and concomitant perilesional edema undergoing en bloc resection. Each patient was evaluated for perilesional brain edema grading. We stratified patients into three groups based on the size of the metastatic lesion and the extent of perilesional edema. Results: The grade of perilesional edema at 30 days after surgical removal did not correlate with the maximum diameter of the metastasis (Pearson's correlation 0.098, p=0.494). In patients with a maximal metastatic diameter ≤2 cm, the grade of perilesional edema before surgical treatment was 1.63 (STD 0.43), while 30 days after removal it was significantly reduced; 0.47 (STD 0.26), p<0.001. Conclusion: The overall mass effect of solitary supratentorial brain metastases is not correlated to the size of the lesion and the grade of the associated perilesional edema should be considered. Surgical en bloc resection can be considered the first choice of treatment in the presence of solitary metastasis ≤2 cm in maximal diameter but with high-grade edema, since this treatment reduces the overall mass effect.
brain metastasis; en bloc resection; overall mass effect; perilesional edema; size of lesion; edema; humans; retrospective studies; brain edema; brain neoplasms; sexually transmitted diseases
01 Pubblicazione su rivista::01a Articolo in rivista
En bloc resection of solitary brain metastasis: the role of perilesional edema / Bruzzaniti, Placido; Lapolla, Pierfrancesco; D'Amico, Alessia; Zancana, Giuseppa; Katsev, Michael; Relucenti, Michela; Familiari, Giuseppe; Mingoli, Andrea; D'Andrea, Giancarlo; Frati, Alessandro; Salvati, Maurizio; Santoro, Antonio; Familiari, Pietro. - In: IN VIVO. - ISSN 0258-851X. - 36:3(2022), pp. 1274-1284. [10.21873/invivo.12827]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1630846
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