Preoperative Metastatic Brain Tumor-Associated Intracerebral Hemorrhage Is Associated With Dismal Prognosis
Motaz Hamed, Niklas Schäfer, Christian Bode, Valeri Borger, Anna‐Laura Potthoff, Lars Eichhorn, Frank A. Giordano, Erdem Güresir, Muriel Heimann, Yon‐Dschun Ko, Jennifer Landsberg, Felix Lehmann, Alexander Radbruch, Elisa Scharnböck, Christina Schaub, Katjana Schwab, Johannes Weller, Ulrich Herrlinger, Hartmut Vatter, Patrick Schuss, Matthias Schneider
Abstract
OBJECT: Intra-tumoral hemorrhage is considered an imaging characteristic of advanced cancer disease. However, data on the influence of intra-tumoral hemorrhage in patients with brain metastases (BM) remains scarce. We aimed at investigating patients with BM who underwent neurosurgical resection of the metastatic lesion for a potential impact of preoperative hemorrhagic transformation on overall survival (OS). METHODS: Between 2013 and 2018, 357 patients with BM were surgically treated at the authors' neuro-oncological center. Preoperative magnetic resonance imaging (MRI) examinations were assessed for the occurrence of malignant hemorrhagic transformation. RESULTS: 122 of 375 patients (34%) with BM revealed preoperative intra-tumoral hemorrhage. Patients with hemorrhagic transformed BM exhibited a median OS of 5 months compared to 12 months for patients without intra-tumoral hemorrhage. Multivariate analysis revealed preoperative hemorrhagic transformation as an independent and significant predictor for worsened OS. CONCLUSIONS: The present study identifies preoperative intra-tumoral hemorrhage as an indicator variable for poor prognosis in patients with BM undergoing neurosurgical treatment.