1328 Laser Interstitial Thermal Therapy in Neurosurgery: A Single Surgeon Experience of 313 Patients

INTRODUCTION: Real-time magnetic resonance imaging–guided focused laser interstitial thermal therapy (LITT) is a minimally invasive surgical treatment choice for challenging intracranial lesions that are either resistant to conventional therapies or located in deep or critical areas of the brain. METHODS: This study constitutes an exploratory cohort analysis encompassing all patients who underwent LITT for brain tumors at a single center between 2013 and 2023. The primary focus was on extent of ablation, time to recurrence, and overall survival. Additionally, we evaluated secondary outcomes, including the rate of complications. Comparative analyses were conducted based on lesion subtypes, and factors predicting outcomes were identified. RESULTS: A total of 313 patients underwent LITT procedures. During a mean follow-up of 10.4 months, 66.8% of patients remained alive and 26.2% of the ablated lesions were recurred. The mean age of the cohort was 60.4 ± 13.3 years, with 58.5% being female. Lesion subtypes treated comprised metastases (30%), glioblastoma multiforme (GBM) (41.6%), low-grade glioma (LGG) (9.1%), radiation necrosis (RN) (11.4%), and meningiomas (2.2%). Mean TTR and OS were 12.2 and 38.1 months, respectively. TTR and OS varied by lesion subtype (P<0.001, log-rank analysis). A high-grade lesion was identified as the single factor linked to recurrence. Age, high-grade lesion, preoperative lesion volume, and readmission within 30 days were identified as factors significantly associated with survival in the multivariable Cox regression analysis. CONCLUSIONS: LITT stands as a secure and feasible ablative treatment choice for intracranial lesions, potentially suitable for specific patient cases otherwise not amenable to surgical intervention. The findings further corroborate the safety of the procedure and its favorable outcomes, underscoring its potential significance in clinical practice.