Craniotomy for brain metastases: a consecutive series of 316 patients

Abstract

In this population study, the annual incidence of a first-time craniotomy for a brain metastasis was 2.6/100,000, the 30-day mortality rate was 3.8%, and median OS was 9.2 months. The well-known prognostic factors were confirmed.

Are melanomas averse to cerebellum? Cerebellar metastases in a surgical series

“…We observed a 30‐day post‐operative mortality rate of 4.3% for patients with cerebellar metastases, findings in accordance to our former series for brain metastases in general . This post‐operative mortality rate is higher than for craniotomies in general in our department , which may be due to the fact that some patients with brain metastasis have advanced extracranial disease at surgery.…”

“…addressed cerebellar metastases as a highly significant negative prognostic marker for survival in multivariate Cox analysis for patients undergoing resection for melanoma, colorectal, and renal cancer metastases, albeit not significant for breast cancer . In our former consecutive series for intracranial metastases, we observed a median OS of 9.2 months for 316 patients with single or multiple lesions undergoing resection with or without post‐operative RT . Cerebellar tumor localization was in this cohort not a significant negative prognostic marker for OS in neither univariate ( P = 0.14) nor in multivariate Cox analysis.…”

“…Malignant melanoma has the highest relative propensity of all primary cancers to metastasize to the brain . Despite melanomas' well‐known predilection for brain parenchyma , melanoma metastases were rarely encountered in cerebellum in our former surgical series for intracranial metastases. This aversion of melanomas to cerebellum has, to the best of our knowledge, not been explicitly addressed in the literature previously.…”

“…This large, consecutive cohort of patients undergoing surgery for cerebellar metastases was undertaken to substantiate the observation that melanomas infrequently metastasize to the cerebellum and to explore the propensity of other primary cancer types to metastasize to the cerebellum. The second objective of this series is to report clinical characteristics, survival, and prognostic factors in patients undergoing surgical treatment of cerebellar metastases, addressed separately from the far more common supratentorial metastases.…”

Estimating the Additive Benefit of Surgical Excision to Stereotactic Radiosurgery in the Management of Metastatic Brain Disease

“…[25][26][27]33 Surgical reports also highlight the importance of age, status of tumor, and performance rating to overall survival. 34,35 Few studies address the relative efficacy of surgical resection vs SRS even when WBXRT is administered. A multi-institutional observational study 7 reported that SRS was equivalent to resection for single brain lesions using earlier trials for comparison.…”