[Surgical treatment for cerebral metastasis of choriocarcinoma (author's transl)]

1. The findings of 30 cases of cerebral metastasis of choriocarcinoma on autopsy were analysed in relation to their localization, depth, and number, and it was proven that the cerebral metastasis was neurosurgically resectable in most cases. 2. Thirty-five cases of choriocarcinoma with cerebral metastasis were treated at Nagoya University Hospital. Twenty-four out of 26 cases treated by chemotherapy alone died within 2 months after the manifestation of cerebral metastasis. Whereas 6 out of 9 patients treated by chemotherapy and surgery survived for over 2 months. Four cases among them survived over 6 months. The lifesaving effects of surgery were marked in this group. 3. Surgery was thought to be especially effective on those patients satisfying the following 3 conditions: I) Degree of brain damage is not severe. II) The lesion is localized at removable site, and the post-operative sequela is anticipated to be insignificant. III) The chemotherapy was not proven to be ineffective. 4. Cerebral metastasis of choriocarcinoma should be treated as follows. If symptoms of increased intracranial pressure are present, removal of tumor or, at least, decompression should be immediately performed. Multi-drug chemotherapy and whole-brain irradiation should be started within several days after surgery. If symptoms are not present, chemotherapy combined with irradiation is the first treatment of choice.