10162-STMO-8 A SINGLE CENTER RETROSPECTIVE ANALYSIS OF AWAKE CRANIOTOMY FOR BRAIN METASTASIS.

Abstract

Abstract BACKGROUND/AIM Awake surgery is often used for resecting glioma, but it is controversial whether it should be performed for brain metastasis, because brain tumor is rather demarcated than glioma. However, a small number of hospitals can perform awake craniotomy by limitation of hospital capacity. Here we show a single center retrospective analysis of awake craniotomy for brain metastasis to examine the safety and efficacy of awake craniotomy. MATERIAL/METHOD We analyzed consecutive 50 cases from January 2016 to May 2023 in our hospital. Rehabilitation staff evaluated their neurological status within a week before and after surgery. RESULT Patients characteristics were as follow. Median age was 62 (16-81). Left side tumor were 43 (86.0%). Frontal lobe was 36 (72.0%),temporal lobe 8 (16.0%), parietal lobe 5 (10.0%), occipital lobe 1 (2.0%). Primary cancer was lung 26 (52.0%), gastrointestinal lesion 7 (14.0%), breast 6 (12.0%), soft tissues 4 (8.0%), uterus 1 and malignant melanoma 1, respectively. Radiation necrosis after stereotactic radiosurgery for brain metastases was 5 (10.0%). Preoperative KPS 100-90 was 25 (50.0%), KPS 80 was 10 (20.0%) and less than or equal to KPS 70 was 15 (30.0%). Gross total removal was 43, partial removal was 7. MMSE of before and after surgery was mean 27.1 and median 29. Median OS was 18.8 months (95%CI: 11.2-526). DISCUSSION/CONCLUSION We selected most awake craniotomy for a tumor on left frontal lobe and each evaluationg scales showed no deterioration. Awake craniotomy for brain metastasis is probed to be performed without deteriorating patient's neurological function.