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Modern Surgical Approaches for Brain Metastases.

Alexander Becker1,2, Alejandro Carrasquilla1, Michael A Vogelbaum1

  • 1Department of Neuro-Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.

Cancer Journal (Sudbury, Mass.)
|January 23, 2026
PubMed
Summary
This summary is machine-generated.

Surgical resection offers symptom relief and local control for brain metastases. This review covers open resection, minimally invasive techniques, and adjuncts like LITT, brachytherapy, and Ommaya reservoirs.

Keywords:
Brain metastasisbrachytherapyfluorescent imagingintraoperative adjunctssurgery

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Area of Science:

  • Neurosurgery
  • Oncology
  • Radiotherapy

Background:

  • Surgical resection is a key treatment for brain metastases, providing symptom relief and local control.
  • Patient selection and surgical adjuncts for brain metastases are becoming more nuanced.
  • Evolving radiotherapy, radiosurgery, and medical oncology paradigms influence surgical decisions.

Purpose of the Study:

  • To review current indications for open resection of brain metastases.
  • To evaluate surgical techniques and minimally invasive strategies.
  • To summarize evidence for intraoperative adjuncts like LITT, brachytherapy, and Ommaya reservoirs.

Main Methods:

  • Review of current literature on surgical resection for brain metastases.
  • Evaluation of open resection techniques.
  • Assessment of minimally invasive strategies and intraoperative adjuncts.

Main Results:

  • Open resection remains a mainstay for brain metastases, offering rapid symptom relief and local control.
  • Minimally invasive strategies and adjuncts are increasingly important considerations.
  • Evidence for laser interstitial thermal therapy (LITT), brachytherapy, and Ommaya reservoirs is summarized.

Conclusions:

  • Surgical management of brain metastases requires careful patient selection and consideration of advanced techniques.
  • Minimally invasive options and adjuncts complement traditional open resection.
  • The integration of surgery with evolving oncologic and radiotherapeutic approaches is critical.