[Surgical treatment of brain metastases from sarcoma]

Brain metastases from sarcoma are rare, and data concerning the treatment and results of therapy are sparse. We retrospectively reviewed a series of 28 patients with brain metastases from sarcoma, who were neuro-surgically treated in single institution over 20 years. There were 15 men and 13 women. In 21 patients the brain lesion was located in the supratentorial region, and in 7 patients infratentorially. The median age at brain metastasis diagnosis was 25 years (range 2.6-68 years). Median time from primary diagnosis to diagnosis of brain metastasis was 26.7 months. Lung metastases were present in 21 patients (76%) (8 synchronous with the brain lesion). Pulmonary metastases were resected in 14 patients (50%). The overall median survival time from diagnosis of primary sarcoma was 38.8 months, and from craniotomy was 6.6 months. The presence or absence of lung lesion did not change the median survival calculated from diagnosis of brain metastasis (7 mos and 4.5 mos, respectively, p < 0.48, log-rank test). Two patients (7%) died within 30 days of operation. One-year survival was 36% and 2-year survival was 18%. Three patients (12%) survived over 5 years. Since brain metastases from sarcoma are refractory to alternative treatment, surgical excision is indicated when feasible. Brain metastases from sarcoma are uncommon and usually occur in association with or following lung metastasis. Long term survival is possible in a small percentage of patients.