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Surgical resection for patients with solid brain metastases: current status.

Peter M Black1, Mark D Johnson

  • 1Brigham and Women's Hospital, Dana-Farber-Brigham and Women's Hospital Cancer Center, and Harvard Medical School, Boston, MA 02115, USA. pblack@partners.org

Journal of Neuro-Oncology
|November 6, 2004
PubMed
Summary

Surgery offers a safe and effective treatment for brain metastases, with low complication and recurrence rates. It is often preferred over radiation for metastatic lesions, especially symptomatic ones.

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Area of Science:

  • Neurosurgery
  • Oncology
  • Radiology

Background:

  • Brain metastases affect up to 40% of cancer patients.
  • Recent advancements in imaging, systemic cancer treatment, and surgical techniques have revolutionized management.
  • Improved detection leads to more frequent identification of metastatic lesions.

Purpose of the Study:

  • To review the current understanding and indications for surgical intervention in brain metastases.
  • To compare surgical outcomes with other treatment modalities like whole brain radiation and radiosurgery.

Main Methods:

  • Review of Class 1 data and other relevant studies on surgical management of brain metastases.
  • Analysis of complication rates, recurrence rates, and patient outcomes.
  • Evaluation of indications for surgical resection.

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Main Results:

  • Surgery is indicated for symptomatic masses, masses with unknown primaries, large lesions (>3 cm), or those causing significant edema.
  • Class 1 evidence suggests surgery is superior to whole brain radiation for metastases.
  • Metastases in eloquent cortex can be safely removed with low complication (<10%) and recurrence rates.

Conclusions:

  • Surgical resection is a highly effective and safe treatment option for brain metastases.
  • Further research is needed to determine the optimal role of radiosurgery or whole brain radiation as adjuncts to surgery.