Article
Benefit of intraoperative MRI in surgery of malignant brain tumors
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Published: | May 20, 2009 |
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Objective: The role of radical surgery as one possible aspect of treating patients with malignant brain tumor is a matter of controversy. We discuss the benefit of the iMRI used in 118 cases of malignant brain tumor surgery versus 78 cases without usage of the iMRI.
Methods: We analyzed 196 patients, who underwent craniotomy for newly diagnosed brain tumor WHO grade III or IV or recurrent brain tumor WHO grade III or IV minus/plus iMRI between September 2005 and October 2007. The influence of concomitants was analyzed using the chi-square test, quality of life was analyzed using the Mann-Whitney-U-test and survival was computed using the Kaplan-Meier method.
Results: Histological analysis showed 60 grade III tumors of which 31 (52.7%) were newly diagnosed and 29 (47.3%) were recurrent tumors as well as 136 grade IV tumors of which 80 (58.8%) were newly diagnosed and 56 (41.2%) were recurrent tumors. Median patient age was 57.4 years (mean, 54.9 years; range, 5–87 years). The male-female ratio was 1.06:1. Concomitants were not significantly different for both groups (no iMRI/iMRI) except for a tendency of more awake surgeries, more carmustine wafer implantations and a higher number of male patients in the iMRI-group. In the iMRI-group we found a prolonged survival for patients with newly diagnosed malignant brain tumor, while the Karnowski performance scale seemed to suffer slightly after radical surgery.
Conclusions: Our data suggest that iMRI-guided radical tumor resection leads to prolonged survival for patients with newly diagnosed malignant brain tumor.