Surgery for brain metastases in Singapore

Area of Science:

• Neurology
• Neurosurgery
• Oncology

Background:

• Complete surgical excision followed by whole brain irradiation is the optimal treatment for single brain metastases.
• The study investigates the rate of surgical excision for brain metastases in Singapore.

Purpose of the Study:

• To determine the proportion of patients with brain metastases undergoing surgical excision.
• To estimate the annual incidence of surgically treatable single brain metastases in Singapore.

Main Methods:

• Retrospective review of operation records at Tan Tock Seng Hospital (1985-1989) for surgical excisions of cerebral metastases.
• Estimation of annual surgically excisable single brain metastasis cases based on cancer registry data (1978-1982) and conservative metastasis rates.

Main Results:

• An average of 11 surgical excisions for brain metastases were performed annually at Tan Tock Seng Hospital.
• Calculations suggest at least 67 cases of surgically excisable single brain metastasis occur annually in Singapore.
• Over 84% of patients with single brain metastasis are not receiving the best possible treatment.

Conclusions:

• A significant treatment gap exists for single brain metastases in Singapore, with most patients not undergoing recommended surgery.
• Barriers include patient fear and lack of physician awareness regarding optimal brain metastasis management.
• Enhanced patient education and physician updates on treatment advances are crucial for improving patient outcomes.