Frontiers in Oncology (Sep 2021)

Preoperative Metastatic Brain Tumor-Associated Intracerebral Hemorrhage Is Associated With Dismal Prognosis

  • Motaz Hamed,
  • Niklas Schäfer,
  • Christian Bode,
  • Valeri Borger,
  • Anna-Laura Potthoff,
  • Lars Eichhorn,
  • Frank A. Giordano,
  • Erdem Güresir,
  • Muriel Heimann,
  • Yon-Dschun Ko,
  • Jennifer Landsberg,
  • Felix Lehmann,
  • Alexander Radbruch,
  • Elisa Scharnböck,
  • Christina Schaub,
  • Katjana S. Schwab,
  • Johannes Weller,
  • Ulrich Herrlinger,
  • Hartmut Vatter,
  • Patrick Schuss,
  • Matthias Schneider

DOI
https://doi.org/10.3389/fonc.2021.699860
Journal volume & issue
Vol. 11

Abstract

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ObjectIntra-tumoral hemorrhage is considered an imaging characteristic of advanced cancer disease. However, data on the influence of intra-tumoral hemorrhage in patients with brain metastases (BM) remains scarce. We aimed at investigating patients with BM who underwent neurosurgical resection of the metastatic lesion for a potential impact of preoperative hemorrhagic transformation on overall survival (OS).MethodsBetween 2013 and 2018, 357 patients with BM were surgically treated at the authors’ neuro-oncological center. Preoperative magnetic resonance imaging (MRI) examinations were assessed for the occurrence of malignant hemorrhagic transformation.Results122 of 375 patients (34%) with BM revealed preoperative intra-tumoral hemorrhage. Patients with hemorrhagic transformed BM exhibited a median OS of 5 months compared to 12 months for patients without intra-tumoral hemorrhage. Multivariate analysis revealed preoperative hemorrhagic transformation as an independent and significant predictor for worsened OS.ConclusionsThe present study identifies preoperative intra-tumoral hemorrhage as an indicator variable for poor prognosis in patients with BM undergoing neurosurgical treatment.

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