Postoperative survival in patients with multiple brain metastases

Area of Science:

• Neurosurgery
• Oncology
• Clinical Outcomes Research

Background:

• Traditionally, surgery for brain metastases is reserved for single lesions.
• An increasing number of patients with multiple brain metastases are candidates for surgical intervention.
• The study addresses the need to evaluate surgical outcomes in this growing patient population.

Purpose of the Study:

• To analyze postoperative survival results in patients with multiple brain metastases undergoing surgery.
• To identify clinical factors that significantly impact patient survival after surgical resection.

Main Methods:

• Retrospective review of 36 patients who underwent resection of 2 or more brain lesions between 2005 and 2010.
• Survival calculated from surgery date to last follow-up or death.
• Analysis of clinical factors including number of metastases, Radiation Therapy Oncology Group (RTPG) class, and extent of resection.

Main Results:

• Overall survival ranged from 16 days to 37.5 months (mean 29 months).
• Favorable survival was associated with fewer brain metastases (2-3 vs. 4-6), lower RTPG class (1 vs. 2 or 3), and complete resection.
• A significant association with favorable outcome was found for the number of brain metastases (P=0.046), RTPG classes (P=0.0192), and extent of resection (P=0.018).

Conclusions:

• Selected patients with multiple brain metastases may benefit from surgical intervention.
• Surgical outcomes appear favorable compared to historical controls treated with whole-brain radiotherapy alone.
• Further research into patient selection criteria for surgery in multiple brain metastases is warranted.