Cerebral metastases as a cause of non - traumatic intracranial hemorrhage: long - term results of surgical treatment

The long - term results of surgical treatment (2005-2013) of metastatic brain damage complicated by tumor hemorrhage were studied in 264 patients, including 87 (32.95%) with hemorrhages from metastases. All metastatic tumors and associated hematomas were removed microsurgically, while block removal of neoplasms was performed in 195 (73.9%) patients, in 69 (26.1%) neoplasms were removed by fragmentation. Patients are stratified by the principle of the histological structure of the primary tumor, divided into classes of RPA (recursive partition analysis). The observation interval (from surgery to a clinically significant event) is from 1 to 72 months (median - 22.6 months). Local relapses occurred in 14 (16.1%) patients from the group with hemorrhages in the tumor and 47 (26.6%) in the rest of the cohort of patients with cerebral metastases (c2=3.59, p=0.059; f=1.97 , p>0.05). With block removal of metastases, the local recurrence rate was 11.7%, with fragmentary - 25.9% (c2=2.804, p=0.095; f=1.597 p>0.05). Medians of non - progressive and overall survival after surgery in all patients did not exceed 4.9 and 9.3 months, respectively. In comparison, the minimum values were observed with metastatic melanoma (1.6 and 6 months) and class III RPA (3.6 and 6.5 months). Surgical treatment is effective in patients with symptomatic hemorrhagic metastases, allowing them to achieve similar local relapses and life expectancy after surgery results with a group of patients without intracerebral hemorrhages from metastases.

brain metastases, intracerebral hemorrhage, local recurrence, intracranial hemorrhage