Simultaneous Resection of Multiple Metastatic Brain Tumors with Multiple Keyhole Craniotomies

Area of Science:

• Neurosurgery
• Oncology
• Surgical Oncology

Background:

• Management of symptomatic patients with multiple brain metastases remains unclear.
• Surgical outcomes after multiple simultaneous craniotomies are not well-described.

Purpose of the Study:

• To describe patient outcomes after simultaneously resecting metastatic brain lesions through multiple keyhole craniotomies.
• To evaluate the safety and efficacy of this surgical approach.

Main Methods:

• Retrospective review of patients undergoing resection of multiple brain metastases in one operation (2014-2016).
• Description of a technique for resecting multiple metastatic lesions via keyhole craniotomies.

Main Results:

• Twenty patients underwent 46 tumor resections; primary sites included lung, melanoma, renal, breast, colon, and testes.
• Postoperatively, 71% of patients showed improved Karnofsky Performance Scale scores, and 64% were weaned off steroids by 2 months.
• The median survival time from surgery was 10.8 months.

Conclusions:

• Simultaneous resection of multiple brain metastases via keyhole craniotomies yields outcomes and surgical risks comparable to single metastasis resection.
• This approach may improve early postoperative Karnofsky Performance Scale scores and facilitate steroid weaning.