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Brain metastases with an unknown primary: a clinical perspective
Journal of Neuro-Oncology
|January 1, 1988
Summary
For patients with brain metastases from an unknown primary cancer, solitary lesions had better survival than multiple lesions. Most patients died from intracranial disease progression, suggesting a need for improved treatment strategies.
Area of Science:
- Neuro-oncology
- Cancer Metastasis
- Neurosurgery
Background:
- Cerebral metastases represent a significant challenge in oncology.
- Unknown primary tumors with brain metastases have unique treatment considerations.
Purpose of the Study:
- To analyze treatment outcomes and survival in patients with cerebral metastases of unknown primary origin.
- To evaluate the impact of metastasis number and treatment modality on patient survival.
Main Methods:
- Retrospective review of 43 patients with cerebral metastases and no identified primary tumor.
- Analysis of surgical interventions (resection, biopsy) and whole brain irradiation (WBRT).
- Survival analysis comparing solitary versus multiple metastases and failure analysis.
Main Results:
- 62.7% of patients had solitary cerebral metastases; 37.2% had multiple.
- Surgical resection was performed in 67.4% of patients; 90.7% received WBRT.
- One-year survival was 20%, significantly better for solitary (p<0.03) versus multiple metastases.
- 68.3% of deaths were due to progressive intracranial disease.
Conclusions:
- Solitary cerebral metastases from an unknown primary portend a better prognosis than multiple metastases.
- Treatment strategies should focus on aggressive intracranial disease control.
- Further research is warranted to optimize therapeutic approaches for this patient population.