Influence on morbidity and mortality of neoadjuvant radiation and chemotherapy among cranial malignancy patients in the postoperative setting

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Paul Narayan HeinE Sander Connolly

Abstract

We sought to assess the impact of neoadjuvant therapy on 30 day mortality and morbidity using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Chemotherapy and radiotherapy are both often indicated for treatment of cranial or systemic malignancy but can have significant adverse effects in the postsurgical setting. Data from 2006 to 2012 were obtained from the national ACS-NSQIP database. A total of 1044 patients were identified who obtained surgery for removal of metastatic brain tumors, of whom 127 received neoadjuvant chemotherapy and 65 neoadjuvant radiotherapy. Our primary outcome was 30 day mortality and secondary outcomes were 30 day surgical and medical morbidities. We selected previously reported preoperative variables to build a univariate and a multivariate model to determine preoperative characteristics most associated with neurosurgical mortality and morbidity. Our study found that neoadjuvant chemotherapy was associated with a 2.4-fold increase in the risk of 30 day mortality compared to the patient cohort who did not receive chemotherapy (p=0.023). Interestingly, there was no statistically significant increase in overall 30 day surgical or medical morbidity for ...Continue Reading

References

Jul 16, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jill S Barnholtz-SloanRaymond E Sawaya
Nov 18, 2005·Surgery·Shukri F Khuri
Jul 10, 2010·Acta neurochirurgica·Munzir Al-ZabinMartin A Proescholdt
Nov 11, 2011·Current Oncology Reports·Eugene Koay, Erik P Sulman
Dec 29, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Paul W SperdutoMinesh Mehta
Nov 26, 2013·Journal of Neurosurgery·John D RolstonAndrew T Parsa
Jul 30, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Nicholas B AbtAli Bydon

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Citations

May 18, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·David J CoteTimothy R Smith
Jun 18, 2016·World Neurosurgery·Alexandra M G LarsenTimothy R Smith
Nov 20, 2016·Journal of Neuro-oncology·Aditya V KarhadeTimothy R Smith

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