Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project

• DOI: 10.3171/jns.2003.98.6.1175
• Publication Date: 2009-05-13T17:54:07Z
• Authors: Susan M. Chang; Ian F. Parney; Michael Mcdermott; Fred G. Barker; Meic H. Schmidt; Wei Huang; Edward R. Laws; Kevin O. Lillehei; Mark Bernstein; Henry Brem; Andrew E. Sloan; Mitchel Berger; _ _
• Keywords: Brain tumor

Object. In many new clinical trials of patients with malignant gliomas surgical intervention is incorporated as an integral part tumor-directed interstitial therapies such gene therapy, biodegradable wafer placement, and immunotherapy. Assessment toxicity a major component evaluating these novel therapeutic interventions, but this must be done in light known complication rates craniotomy for tumor resection. Factors predicting neurological outcome would also helpful patient selection surgically based trials. Methods. The Glioma Outcome Project prospectively compiled database containing information on 788 that captured practice patterns outcomes. Patients series who underwent their first or second were analyzed separately presenting symptoms, characteristics, perioperative complications. Preoperative intraoperative factors possibly related to evaluated. There 408 craniotomies (C1 group) 91 ones (C2 group). Both groups had similar characteristics except median age (55 years the C1 group compared 50 C2 group; p = 0.006). Headache was more common at presentation group, whereas papilledema altered level consciousness undergoing surgeries. Perioperative complications occurred 24% 33% (p 0.1). Most same better neurologically after surgery, (18%) displayed worsened status than those (8%; 0.007). Karnofsky Performance Scale score and, size important predictors. Regional both groups. Systemic infections frequently (4.4 0%; < 0.0001) did depression (20 11%; 0.02). mortality rate 1.5% 2.2% not significant). length hospital stay 4 days each group. Conclusions. occur slightly often following glioma craniotomy. This should considered when toxicities from local requiring Nevertheless, most are stable improved either data set may serve benchmark neurosurgeons others discussion operative risks gliomas.