Prognostic factors Affecting Survival Time in Patients with Metastatic Brain Parenchymal Tumors

This study was conducted on 60 metastatic brain parenchymal tumor patients admitted at this hospital between January of 1987 and July of 1993. The mean age of the patients was 54, the youngest 26 and the oldest, 78. The ratio of male v.s. female was 1:2,3,50 were single metastatic and 10 were multiple. The following are the results of the analyses of the factors affecting the prognosis of metastatic brain parenchymal tumor patients: The group operated on showed a significantly prolonged life-span as compared with the group without operation, which was also phenomenal among the single metastatic patients. Among the primary tumors, breast cancer had the longest median survival period, 20 months, and the shortest survival period was one month with the gasrointestinal tumor. As for clinical grade and survival span, those above the karnofsky scale of 80 survived a median of six months, and those below 50 survived for 2 months. The group with favorable clinical conditions before operation resulted in a significantly long life span, Especially in the group with 80 or above of the Karnofsky scale, the operated group showed a far more excellent prognosis as compared to the non operated group. The median survival time was 20 months in the group with more than 12months as an interval between diagnoses of primary tumor and metastasis, wherease it was 3 months for the group with an interval of less than6 months. Thus, the longer the interval, the better the prognosis, This fact was statistically significant Among the patients with an interval of 12 months or more, the operated group also showed better prognosis than the nonoperated group. The mean six months survival rate was 33.3%, the one-year rate was 23.3%, the two-year rate was 10.0% in all cases. The longest survival time was 36 months. The whole body metastasis was the most common cause of death accounting for 64.2%.

Posterior and Anterolateral Approaches in a Single Stage to Dumbbell Tumors of the Spine

The surgical approach to spinal tumors varies not only with the level and location of the tumor, but also with the type and extent of the tumor. Some of the dumbbell neurofibroma(neurilemmoma) can be removed through simple laminectomy, but usually are approached through two separate incisions by two stages. In this report, posterior and anterolateral approaches in a single stage to dumbbell neurofibroma(neurilemmoma) of the spinal region are described. This approach provides full exposure of intra- and paraspinal portions of the tumor, thus permitting safe dissection and total removal. Six patients who underwent this procedure are described to illustrate its application.