Results of surgical treatment for cerebral metastases

Cerebral metastases are commonly encountered, with an incidence ranging from 20 to 30% of cancer cases. Medical and radiation therapy confer median survival ranging from 3 to 6 months only. A retrospective review of patients undergoing surgery with radiotherapy from January 1997 to January 2000 involved 26 patients (13 males, 13 females), with a mean age of 53.1 years (range 30-69 years). The mean follow-up was 15.8 months (range 1.5-27 months). The primary cancer was breast in nine cases, eight were lung cancers, six colonic cancers, two unknown primaries and one was a soft tissue sarcoma. Patients with extracranial secondaries numbered 17 (61.5%). Patients stayed on average for 15.4 days. No intracranial complications occurred postoperatively. No mortalities occurred in the first month and 11 patients (42.3%) were alive at 1 year. Two patients underwent a radiosurgical boost and six patients underwent adjuvant chemotherapy. Overall median survival was 9 months (95% confidence interval 7.3-12.9 months). Factors which may favour longer survival were female sex (median of 12 vs 6.1 months), younger patients (median of 12 vs 5.8 months) and breast cancer (median of 9 months). Surgical treatment appears beneficial, with subgroups such as breast cancer possibly doing better.