Evidence map›Paper›PMID 35092549›Full record

SynthesisJournal of neuro-oncology2022

Postoperative CT scans after resection of brain metastases: neurosurgical routine or added value?

Kaiyun Yang, Alexander P Landry, Majid Aljoghaiman, Enrique Gutierrez, Matthias Millesi, Matheuss Leite, Aristotelis Kalyvas, Paola Anna Jablonska, Jaclyn Vialet, Jessica Weiss and 7 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.5field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 3 countries.

Kaiyun YangDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Alexander P LandryDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. alex.landry@mail.utoronto.ca.ORCID http://orcid.org/0000-0002-7250-8466
Majid AljoghaimanDepartment of Neurosurgery, McMaster University, Hamilton, ON, Canada.
Enrique GutierrezDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Matthias MillesiDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Matheuss LeiteDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Aristotelis KalyvasDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Paola Anna JablonskaDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Jaclyn VialetMedical Library, North Shore University Hospital, Manhasset, NY, USA.
Jessica WeissDepartment of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Barbara-Ann MillarDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Tatianna ConradDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Normand LaperriereDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Mark BernsteinDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Gelareh ZadehDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
David ShultzDepartment of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Paul N KongkhamDepartment of Neurosurgery, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. paul.kongkham@uhn.ca.
University of Toronto · CAMcMaster University · CANorth Shore University Hospital · USPrincess Margaret Cancer Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetastasis is the most common brain tumor in adults. It is the standard of care at most North American centers to obtain an early postoperative imaging after their resection. However, the necessity of this practice in the absence of a new postoperative deficit remains unclear.

methodsWe retrospectively reviewed our surgical cohort of patients who underwent resection of brain metastases from July 2018 to June 2019. We collected demographic data and reviewed results of routine postoperative CT scans and neurological morbidities to examine the diagnostic and therapeutic yield of an early postoperative scan. In addition, we performed a systematic review of the topic.

resultsOur review included 130 patients, all of whom underwent gross total resection of one or more brain metastases. On postoperative CT, none had unexpected findings such as cavity hematoma or new ischemia; no changes in management resulted from postoperative imaging. One patient required a higher dose of dexamethasone on postoperative day 4 for delayed hemiparesis and aphasia due to cerebral edema. Three additional patients underwent a wound washout for delayed infection during a subsequent admission. Our systematic review identified three additional studies; in a combined cohort of 450 patients (including our own), no patients had clinically actionable findings on routine postoperative CT.

conclusionsFollowing resection of brain metastases, a routine postoperative CT scan has low diagnostic yield and did not change patient management in any cases examined in this work.

Indexed as

Brain NeoplasmsTomography, X-Ray ComputedAdultCraniotomyHumansPostoperative PeriodRetrospective StudiesClinical outcomesComputed tomographyCraniotomyMetastasisNeurosurgery

Identifiers

PMID35092549
OpenAlexW4210555340

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.