Evidence map›Paper›PMID 37945819›Full record

ArticleJournal of neuro-oncology2023

Safety of microneurosurgical interventions for superficial and deep-seated brain metastases: single-center cohort study of 637 consecutive cases.

Stefanos Voglis, Luis Padevit, Christiaan Hendrik Bas van Niftrik, Vincens Kälin, Benjamin Beyersdorf, Raffaele Da Mutten, Vittorio Stumpo, Jacopo Bellomo, Johannes Sarnthein, Victor Egon Staartjes and 4 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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

14 authors at 1 institution in 2 countries.

Stefanos Voglis *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. stefanos.voglis@usz.ch.ORCID http://orcid.org/0000-0002-1514-1442
Luis Padevit *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-2461-0404
Christiaan Hendrik Bas van NiftrikDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-0930-8717
Vincens KälinDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Benjamin BeyersdorfDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-9272-3115
Raffaele Da MuttenDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-2645-0865
Vittorio StumpoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-8175-0035
Jacopo BellomoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0009-0005-8945-4838
Johannes SarntheinDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-9141-381X
Victor Egon StaartjesDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-1039-2098
Alessandro CarrettaDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Niklaus KrayenbühlDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-4973-7527
Luca RegliDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-4639-4474
Carlo SerraDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-7305-550X
University of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMicroneurosurgical techniques have greatly improved over the past years due to the introduction of new technology and surgical concepts. To reevaluate the role of micro-neurosurgery in brain metastases (BM) resection in the era of new systemic and local treatment options, its safety profile needs to be reassessed. The aim of this study was to analyze the rate of adverse events (AEs) according to a systematic, comprehensive and reliably reproducible grading system after microneurosurgical BM resection in a large and modern microneurosurgical series with special emphasis on anatomical location.

methodsProspectively collected cases of BM resection between 2013 and 2022 were retrospectively analyzed. Number of AEs, defined as any deviations from the expected postoperative course according to Clavien-Dindo-Grade (CDG) were evaluated. Patient, surgical, and lesion characteristics, including exact anatomic tumor locations, were analyzed using uni- and multivariate logistic regression and survival analysis to identify predictive factors for AEs.

resultsWe identified 664 eligible patients with lung cancer being the most common primary tumor (44%), followed by melanoma (25%) and breast cancer (11%). 29 patients (4%) underwent biopsy only whereas BM were resected in 637 (96%) of cases. The overall rate of AEs was 8% at discharge. However, severe AEs (≥ CDG 3a; requiring surgical intervention under local/general anesthesia or ICU treatment) occurred in only 1.9% (n = 12) of cases with a perioperative mortality of 0.6% (n = 4). Infratentorial tumor location (OR 5.46, 95% 2.31-13.8, p = .001), reoperation (OR 2.31, 95% 1.07-4.81, p = .033) and central region tumor location (OR 3.03, 95% 1.03-8.60) showed to be significant predictors in a multivariate analysis for major AEs (CDG ≥ 2 or new neurological deficits). Neither deep supratentorial nor central region tumors were associated with more major AEs compared to convexity lesions.

conclusionsModern microneurosurgical resection can be considered an excellent option in the management of BM in terms of safety, as the overall rate of major AEs are very rare even in eloquent and deep-seated lesions.

Indexed as

Brain NeoplasmsLung NeoplasmsCohort StudiesHumansNeurosurgical ProceduresRetrospective StudiesAdverse eventsBrain metastasesComplicationsSurgical resection

Identifiers

PMID37945819
PMCPMC10689541
OpenAlexW4388551350

What OpenQuestion holds

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Registered trials

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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.