Surgical treatment of single brain metastasis: factors associated with survival

The results of surgical excision of solitary intracerebral metastases followed by whole-brain radiation therapy between 1972 and 1978 in a series of 78 patients were analyzed. The overall median survival of the series was 6 months with a 1-year survival rate of 29%. Statistical analyses of the data revealed that patients who presented with a cerebral metastasis 1 year or more after diagnosis of the primary cancer had a significantly longer survival than those in whom the metastasis was detected within 1 year (P less than .04). Patients with mild or no neurological deficits at time of craniotomy had a longer median survival and a 1-year survival of 44% (P less than .01). The presence of metastases at one or two other sites did not significantly affect overall survival except in those patients in whom the brain metastasis was detected more than 1 year after diagnosis of the primary tumor. Factors found to affect survival in this study may be useful in predicting survival of future patients similarly treated.