Abstract
ObjectiveSurgical resection represents a common treatment modality in patients with brain metastasis (BM). Postoperative prolonged mechanical ventilation (PMV) might have an enormous impact on the overall survival (OS) of these patients suffering from advanced cancer disease. We therefore have analyzed our institutional database with regard to a potential impact of PMV on OS of patients who had undergone surgery for brain metastases.Methods360 patients with surgically treated brain metastases were included. The definition of PMV consisted of postoperative mechanical ventilation lasting for more than 48 hours. Analysis of survival incorporating established prognostic factors such as age, location of BM, and preoperative physical status was performed.Results14 of 360 patients with BM (4%) suffered from postoperative PMV after surgical treatment of BM. Patients with PMV presented in a significantly more impaired neurological condition preoperatively than patients without (p<0.0001). Multivariate analysis determined PMV to be a significant prognostic factor for OS after surgical treatment in patients with BM, independent of other predictive factors (p<0.0001).ConclusionsThe present study demonstrates postoperative PMV as significantly related to poor OS in patients with surgically treated BM. Postoperative PMV is a so far underestimated prognostic predictor, but might be utilized for optimized patient management early in the postoperative phase. For this purpose, the results of the present study should encourage the initiation of further scientific efforts.
Highlights
Compared to previous decades, modern intensive care medicine provides a significant survival advantage for critically ill patients due to a continuous gain in knowledge and further refined technology [1]
In the case of a resulting prolonged need for mechanical ventilation, in addition to the physical challenges, the necessary adjuvant therapy may be postponed with devastating consequences - as recently demonstrated in patients with glioblastoma and meningioma [7, 8]
Despite various studies indicating the impact of prolonged mechanical ventilation (PMV) in different cancer patients, we are unaware of any preceding detailed research evaluating a possible prognostic effect of PMV in patients suffering from brain metastases (BM)
Summary
Modern intensive care medicine provides a significant survival advantage for critically ill patients due to a continuous gain in knowledge and further refined technology [1]. Patients with a diagnosis of cancer and the need for mechanical ventilation (e.g., due to respiratory failure) have a grim prognosis, as numerous previous studies have documented [2,3,4]. Patients with brain metastases (BM) are referred to the group of patients with advanced-stage cancer [5]. As such, they often have already undergone multiple debilitating surgeries and other treatments. In the case of a resulting prolonged need for mechanical ventilation, in addition to the physical challenges, the necessary adjuvant therapy may be postponed with devastating consequences - as recently demonstrated in patients with glioblastoma and meningioma [7, 8]. It is imperative to address the impact of prolonged mechanical ventilation (PMV) on cancer patients and especially those with BM. Despite various studies indicating the impact of PMV in different cancer patients, we are unaware of any preceding detailed research evaluating a possible prognostic effect of PMV in patients suffering from BM
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
