Management of intracranial metastases

Of 223 patients with intracranial metastases, 161 underwent removal of a presumed solitary lesion and 29 were treated by burr-hole biopsy. Results of radical surgery were better than those of biopsy alone in terms of survival. Quality and duration of survival were poorer in patients who had infratentorial metastases removed than in those who underwent surgery for supratentorial metastases. In this second group only patients with breast cancer benefited from surgery, though a few women with bronchial carcinoma also did well. The interval removal of a primary tumour and development of intracranial symptoms did not influence outcome. Evidence of a previous primary tumour should not lead to the assumption that intracranial symptoms are caused by a metastasis.