NOTQ-08 INFLUENCE OF NEUROSURGICAL RESECTION ON PSYCHO-ONCOLOGICAL BURDEN IN PATIENTS WITH BRAIN METASTASES
Tommaso Araceli, Eva-Maria Stoerr, Lina Winkler, Anna Fischl, Peter Hau, Elisabeth Bumes, Nils Ole Schmidt, Martin ProescholdtAbstract
Objective
Patients with brain metastases (BM) frequently experience substantial psycho-oncological distress. While neurosurgical treatment is increasingly performed, its effect on psychological burden remains unclear. This study evaluates changes in psycho-oncological distress before and after surgical resection of BM, aiming to determine whether neurosurgical intervention alleviates distress.
Methods
We analyzed 103 patients (45 female, 58 male; median age 59.8 years) undergoing microsurgical resection of BM between January 2016 and January 2024. The most common primary tumors were lung cancer (40.8%), melanoma (27.2%), and breast cancer (7.8%). Psycho-oncological burden was assessed pre- and postoperatively using the Hornheider Screening Instrument (HSI, 84.5%) or the Distress Thermometer (DT, 15.5%). Postsurgical assessment was conducted after a median of 4.5 days (range 2–42). Median postoperative Karnofsky Performance Status (KPS) was 90% (range 50–100%). Surgical complications occurred in 25.2% of patients, most commonly worsening of preexisting neurological deficits (13.6%) and wound complications (6.8%).
Results
Postoperatively, 16.5% of patients showed no change in distress, 45.6% improved, and 37.9% worsened. Patients with progressive intracranial or systemic disease had significantly lower improvement rates compared with those with stable disease (16.6% vs. 47.4%, p = 0.033). Preoperatively, 44.7% of patients exceeded the threshold for psycho-oncological intervention; this proportion decreased significantly to 41.8% after surgery (p = 0.020). Median HSI scores declined from 4 to 3 (p = 0.036), whereas DT scores did not change significantly (p = 0.431).
Conclusion
Neurosurgical resection may reduce psycho-oncological distress in patients with BM, particularly in those with stable intracranial and systemic disease.