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27.06.2022 | Research

Accuracy and safety of 101 consecutives neurosurgical procedures for newly diagnosed central nervous system lymphomas: a single-institution experience

verfasst von: Ilyes Aliouat, Alessandro Moiraghi, Giorgia Antonia Simboli, Rudy Birsen, Angela Elia, Alexandre Roux, Jérôme Tamburini, Edouard Dezamis, Eduardo Parraga, Chiara Benevello, Diane Damotte, Corentin Provost, Catherine Oppenheim, Didier Bouscary, Fabrice Chretien, Marc Zanello, Johan Pallud

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2022

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Abstract

Introduction

Brain surgery is required to ascertain the diagnosis of central nervous system lymphoma. We assessed the diagnostic yield and safety of the surgical procedures, the predictors of postoperative morbidity, and of overall survival.

Methods

Observational single-institution retrospective cohort study (1992–2020) of 101 consecutive adult patients who underwent stereotactic biopsy, open biopsy, or resection for a newly diagnosed central nervous system lymphoma.

Results

The diagnostic yield was 100% despite preoperative steroid administration in 48/101 cases (47.5%). A preoperative Karnofsky Performance Status score less than 70 (p = 0.006) was an independent predictor of a new postoperative focal neurological deficit (7/101 cases, 6.9%). A previous history of hematological malignancy (p = 0.049), age 65 years or more (p = 0.031), and new postoperative neurological deficit (p < 0.001) were independent predictors of a Karnofsky Performance Status score decrease 20 points or more postoperatively (13/101 cases, 12.9%). A previous history of hematological malignancy (p = 0.034), and preoperative Karnofsky Performance Status score less than 70 (p = 0.024) were independent predictors of postoperative hemorrhage (13/101 cases, 12.9%). A preoperative Karnofsky Performance Status score less than 70 (p = 0.019), and a previous history of hematological malignancy (p = 0.014) were independent predictors of death during hospital stay (8/101 cases, 7.9%). In the 82 immunocompetent patients harboring a primary central nervous system lymphoma, age 65 years or more (p = 0.044), and time to hematological treatment more than 21 days (p = 0.008), were independent predictors of a shorter overall survival. A dedicated hematological treatment (p < 0.001) was an independent predictor of a longer overall survival.

Conclusion

Brain biopsy is feasible with low morbidity for central nervous system lymphomas. Postoperatively, patients should be promptly referred for hematological treatment initiation.

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Titel: Accuracy and safety of 101 consecutives neurosurgical procedures for newly diagnosed central nervous system lymphomas: a single-institution experience
verfasst von: Ilyes Aliouat
Alessandro Moiraghi
Giorgia Antonia Simboli
Rudy Birsen
Angela Elia
Alexandre Roux
Jérôme Tamburini
Edouard Dezamis
Eduardo Parraga
Chiara Benevello
Diane Damotte
Corentin Provost
Catherine Oppenheim
Didier Bouscary
Fabrice Chretien
Marc Zanello
Johan Pallud
Publikationsdatum: 27.06.2022
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2022
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-022-04069-6

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