According to a 2000 article in "Neurosurgery Quarterly" by Dr. Max Kole, primary central nervous system tumors occur in 10,000 to 17,000 patients annually in the United States. Glioblastoma multiforme, the most aggressive brain tumor accounts for more than half of these tumors in adults. Standard of care for high-grade gliomas includes surgery, radiotherapy, and chemotherapy because the tumor invades surrounding tissue. Despite these current treatments, the median survival from time of diagnosis equals one added year.
Perioperative Complications
Surgical complications can be divided into perioperative mortality and neurological, regional, and systemic morbidity. Perioperatively, the surgeon performs a craniotomy, which involves cutting through the skull and exposing the brain. According to Dr. R. Sawaya in a study published in 1998 in the journal "Neurosurgery," the mortality rate for craniotomy for brain tumors ranges from two to three percent.
Major Neurological Complications
Due to improved surgical techniques, the 30-day operative mortality has dropped to less than three percent. The major complication from surgical resection of a glioblastoma multifore tumor is neurologic impairment. According to the CNC Clinic Jordan, up to 40 percent of postoperative survivors have no neurological deficit or suffer from minimal deficits such as facial weakness; another 26 percent suffer from paralysis of one side of the body, or hemiparesis, but remain ambulatory and able to care for themselves.
Major neurologic complications occur at a rate of three to 20 percent, depending on the location of the tumor and the extent of resection. According to the NY Times.com, the major neurological complications include loss of ability to interact or function, and permanent, worsening and severe loss of brain function.
Regional Complications
Regional complications include postoperative hematoma, water on the brain, known as hydrocephalus, and wound infections. The incidence of postoperative hematoma ranges from two to five percent, while the incidence of hydrocephalus and wound infections range from one to two percent.
Systemic Complications
Systemic complications include gastritis, pneumonia, sepsis, deep vein thrombosis and pulmonary embolism. According to Dr. R. Sawaya, in the journal "Neurosurgery," systemic complications occur in approximately eight percent of patients undergoing craniotomy for tumor.
References
- "Neurosurgery Quarterly"; Malignant Glioma Surgery: Complication Avoidance; Max Kole and Jack Rock; 2002; 12(3):251--258
- "Neurosurgery"; Neurosurgery outcomes in a modern series of 400 craniotomies for the treatment of parenchymal tumors; R. Sawaya; 1998;
- NY Times: Brain Tumor - Primary - Adults
- Mayo Clinic:Central Nervous System Tumors
- CNS Clinic Jordan: Surgery and Complications
