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Updated: Aug 11, 2026
Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
Selective excision of metastatic brain tumors originating in the motor cortex with preservation of function
Robert J Weil1, Russell R Lonser
1Brain Tumor Institute, Taussig Cancer Center/Desk R-20, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA. weilr@ccf.org
Purpose:
Brain metastases are common in patients with cancer and can cause considerable morbidity or death. Metastasis in eloquent areas of the brain, particularly the primary motor cortex, may present significant treatment challenges.
Patients And Methods:
Seventeen consecutive patients with metastasis within the primary motor cortex underwent selective microsurgical tumor resection. Operative, hospital, neuroimaging, and follow-up information was reviewed.
Results:
There were 10 women and seven men (mean age, 54.3 years) who underwent 17 operations for symptomatic brain metastases. Motor cortex was identified and tumor (mean volume, 10.2 cm(3)) was completely resected in all patients. Three patients had transient or reversible complications. Karnofsky performance scores improved in 16 of 17 patients at 4 weeks postoperatively, with a mean improvement of 1.8 grades compared with preoperative scores (P < .05). Overall survival of 16 patients with distant follow-up (> 6 months or until death) averaged 10.6 +/- 4.4 months, with nine of 16 (56%) assessable patients surviving 1 year or longer. Survival of these 16 patients, by recursive partitioning analysis (RPA), was 11.2, 13.3, and 6.7 months for RPA classes I, II, and III, respectively. The cause of death in 14 of 15 patients who have died was progressive systemic disease; in one patient it was a combination of systemic and distant CNS disease progression. There were no local CNS recurrences.
Conclusion:
Complete microsurgical resection of metastatic tumors in the primary motor cortex is feasible and efficacious, results in a sustained improvement in performance outcomes, and permits satisfactory long-term survival.
Insights
Complete microsurgical resection of brain metastases in the primary motor cortex is feasible and effective. This procedure improves patient performance outcomes and allows for satisfactory long-term survival.
Area of Science:
- Neurosurgery
- Oncology
- Neurology
Background:
- Brain metastases are a frequent complication in cancer patients, often leading to significant morbidity and mortality.
- Metastases in critical brain areas, such as the primary motor cortex, pose substantial therapeutic challenges.
Purpose of the Study:
- To evaluate the feasibility and efficacy of selective microsurgical resection for brain metastases located in the primary motor cortex.
- To assess the impact of this surgical approach on patient performance outcomes and long-term survival.
Main Methods:
- Seventeen consecutive patients with primary motor cortex brain metastases underwent microsurgical tumor resection.
- Data on operative details, hospital course, neuroimaging, and follow-up were retrospectively reviewed.
Main Results:
- Complete tumor resection was achieved in all 17 patients.
- Karnofsky performance scores improved significantly in 16 of 17 patients within 4 weeks postoperatively.
- The 1-year survival rate was 56%, with an average survival of 10.6 months. No local central nervous system recurrences were observed.
Conclusions:
- Complete microsurgical resection of metastatic tumors in the primary motor cortex is a safe and effective treatment option.
- This surgical approach leads to sustained improvements in functional outcomes and satisfactory long-term survival for patients.
- Microsurgical resection can be considered a viable strategy for managing brain metastases in eloquent brain regions.
