Retrospective autoevaluation of the results of intrinsic brain tumor surgeries – consecutive cohort of 270 surgeries within one neurosurgical center of the NOS ČOS (Neurooncological section of the Czech Oncology Society) from 2015–2017


Authors: R. Bartoš 1,2;  D. Ospalík 3;  A. Malucelli 1;  P. Vachata 1;  M. Sameš 1;  T. Kazda 4,5;  D. Šmejkalová-Musilová 6;  F. Třebický 7
Authors‘ workplace: Neurochirurgická klinika UJEP, a Masarykova nemocnice, KZ a. s., Ústí, nad Labem 1;  Anatomický ústav, 1. LF UK, Praha 2;  Neurologické oddělení, Masarykova, nemocnice, KZ a. s., Ústí nad Labem 3;  Klinika radiační onkologie Masarykova, onkologického ústavu, Brno 4;  Klinika radiační onkologie LF MU, Brno 5;  Onkologické oddělení, Komplexní, onkologické centrum, Masarykova, nemocnice, KZ a. s., Ústí nad Labem 6;  Ústav radiační onkologie, Nemocnice, na Bulovce, Praha 7
Published in: Cesk Slov Neurol N 2019; 82(4): 401-409
Category: Original Paper
doi: 10.14735/amcsnn2019401

Overview

Aim: Retrospective evaluation of a consecutive cohort of adult intrinsic brain tumor patients operated in Ústí nad Labem (Czech Republic) from 2015 to 2017 focusing on the assessment of postoperative morbidity.

Patients and Methods: Basic evaluated variables included neurological morbidity, subgaleal cerebrospinal fluid collection or duration of hospitalization. In the subgroup of patients with high-grade gliomas, the parameters of the organization of subsequent oncological care, such as the waiting time until the start of radiotherapy were evaluated, together with overall survival estimations.

Results: A total of 270 surgeries were performed (average age 60 years, 59% men). Newly dia­gnosed glioblastomas (GBM) represented 37.4% of the surgeries, while metastases were 32.6% of the total. Severe neurological morbidity was observed in 18 patients (6.7%). Subgaleal cerebrospinal fluid collection was dia­gnosed in 13% of patients. The average length of hospitalization was 6.6 days. About 30% of patients underwent complete oncological treatment. The median waiting time for radiotherapy was 46 days after surgery (no effect on overall survival). The median overall survival of patients with GBM was 8.8 months (95% CI 2.2–13.4). Significantly longer overall survival was observed in patients who were able to undergo treatment according to the Stupp regimen (22.6 vs. 4.3 months, P < 0.001), those after resection vs. bio­psy (12.4 vs. 4 months, P < 0.001) and younger patients ≤ 60 years (19.4 vs. 5.1 months, P < 0.001).

Conclusion: We observed overall low postoperative morbidity in our cohort of neurooncology patients. Self-evaluation of results is an integral part of complex neurosurgical care.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

neurooncology – brain tumor – neurosurgery – radiotherapy


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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