Effect of Surgically Acquired Neurological Deficits on Mortality Among Patients with Brain Metastases

Purpose To evaluate the association between surgically acquired neurological deficits and mortality among patients who underwent surgical resection of brain metastases. Methods Patients who underwent surgical resection of brain metastases at our institution between 2011 and 2019 were included. Surgically acquired neurological deficits were defined as dysarthria/aphasia, ataxia, hemiparesis, and visual field loss. A Cox proportional hazards model adjusting for potential confounders was constructed to evaluate whether surgically acquired neurological deficits were independently associated with a higher risk of overall mortality. Results A total of 153 patients were included in the analysis. 3.3% (5 patients) had a surgically acquired neurological deficit. On univariate time-to-event analysis, there was no statistically significant association between the development of a surgically acquired neurological deficit and mortality (HR=1.12; 95% CI=0.15, 8.24; p=0.910). On multivariate time-to-event analysis adjusting for potential confounders, there was also no statistically significant association between the development of a surgically acquired neurological deficit and mortality (HR=1.53; 95% CI=0.20, 11.9; p=0.683). Conclusion The development of a surgically acquired neurological deficit was not associated with overall mortality. Although this conclusion differs from other studies in the literature, the goal of surgical resection remains unchanged – to resect as much tumor as possible while still preserving neurological function.