Abstract ES1-1: Advances in the Neurosurgical Management of CNS Metastases

Abstract

Abstract As the overall survival of patients with metastatic breast cancer improves, greater attention has been drawn to involvement specific to the central nervous system (CNS). Brain metastases are the most common intracranial tumor in adults with breast cancer representing the second most common type of CNS brain metastasis. These lesions are thought to develop in up to 20% of breast cancer patients with over 15,000 new cases predicted in the United States each year. Spinal metastases, some with involvement of the spinal cord, are also a frequent occurrence in the breast cancer patient with up to 30% of patients developing this form of the disease. Unfortunately, new systemic therapies for CNS metastases have had little impact on disease control, a critical factor in the improvement of quality of life and survival for this group of patients. Data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reveal that one third of intra-cranial and one-half of spinal breast cancer patients with neurosurgically treated CNS metastases are alive at 1 year and that the overall post-operative survival has increased over time for spinal fusion procedures. We propose to review the current state of knowledge, the existing barriers to more successful neurosurgical treatment, and the future goals for treating CNS metastases with neurosurgical intervention. We will 1) review the clinical factors associated with the development of CNS metastases, 2) summarize current neurosurgical treatment strategies with evidence-based outcome data, 3) highlight possible directions for future research efforts. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr ES1-1.