Surgical 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.

In the light of an aging population and ongoing advances in cancer control, the optimal management in geriatric patients with brain metastases (BM) poses an increasing challenge, especially due to the scarce data available. We therefore analyzed our institutional data with regard to factors influencing overall survival (OS) in geriatric patients with BM.

Objective: Tumor-associated proptosis comprises a frequent phenomenon that negatively impacts quality of life in patients suffering from spheno-orbital meningioma (SOM). Therefore, proptosis outcome represents an important measure in meningioma surgery. In the current study, we analyzed our institutional database in order to evaluate the recovery of tumor-associated proptosis in patients with SOM. Methods: Between 2009 and 2019, 32 patients with SOM underwent surgical treatment at the authors' institution. The exophthalmos index (EI) was calculated by means of preoperative and postoperative tumor-associated proptosis. Patients with preoperative EI ≥ 1.1 were included in further analysis. Further, we performed a systematic review of the contemporary literature. Favorable proptosis outcome was defined as postoperative decreased EI compared with preoperative EI. Results: Overall, 25 of 32 patients with SOM (78%) suffered from preoperative proptosis in the present series. Preoperative mean EI of 1.37 ± 0.18 decreased after surgical treatment to a postoperative mean EI of 1.15 ± 0.1 during follow-up (p < 0.0001). Systematic review of the literature revealed three studies with individual data on preoperative and postoperative EI measurements leading to a total of 103 patients; 100 of 103 patients (97%) with SOM and preoperative proptosis achieved favorable outcome. Conclusions: The EI provides a comparable standard in evaluation of surgical outcome in patients with tumor-associated proptosis due to SOMs. The large dataset consisting of pooled individual patient data from the systematic review of the literature and the present case series support the assumption that surgical treatment is highly effective in the treatment of tumor-associated proptosis in SOM.

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).

Patients with spinal metastasis (SM) are at advanced stages of systemic cancer disease. Surgical therapy for SM is a common treatment modality enabling histopathological diagnosis and the prevention of severe neurological deficits. However, surgery for SM in this vulnerable patient cohort may require prolonged postoperative intensive care treatment, which could adversely affect the anticipated benefit of the surgery. We therefore assessed postoperative prolonged mechanical ventilation (PMV) as an indicator for intensive care treatment with regard to potential correlations with early postoperative mortality and overall survival (OS).