Modern Surgical Approaches for Brain Metastases

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.