Skip to main content
SpringerLink
Log in

Epidemiology of Central Nervous System Metastases

  • Chapter
  • First Online:
Central Nervous System Metastases

Abstract

The central nervous system (CNS) is a common site of metastatic spread of systemic cancer and continues to be a major cause of morbidity and mortality. Although brain metastases are the most common brain tumors, the exact incidence or prevalence is unavailable, and estimates vary considerably. Cancers most likely to metastasize to the brain are lung, breast, melanoma, renal, and colorectal cancers. The incidence of brain metastases varies widely between these cancers, as well as the number of brain metastases, their spatial distribution, and the order in which they occur (i.e., synchronously or metachronously). Factors such as the primary tumor, their genetic profile, and patient- and tumor-related characteristics contribute to the incidence of brain metastases. Understanding these patterns may guide clinicians in counselling individual patients in daily clinical practice, as prognosis of the underlying disease is a critical factor in treatment decision-making.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organisation. http://www.who.int/news-room/fact-sheets/detail/cancer. Accessed 4 Sept 2018.

  2. Rouse C, Gittleman H, Ostrom QT, Kruchko C, Barnholtz-Sloan JS. Years of potential life lost for brain and CNS tumors relative to other cancers in adults in the United States, 2010. Neuro Oncol. 2016;18(1):70–7.

    Article  PubMed  Google Scholar 

  3. Pekmezci M, Perry A. Neuropathology of brain metastases. Surg Neurol Int. 2013;4(Suppl 4):S245–55.

    PubMed  PubMed Central  Google Scholar 

  4. DeAngelis LM. Brain tumors. N Engl J Med. 2001;344(2):114–23.

    Article  CAS  PubMed  Google Scholar 

  5. Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Curr Oncol Rep. 2012;14(1):48–54.

    Article  PubMed  Google Scholar 

  6. Soffietti R, Ruda R, Trevisan E. Brain metastases: current management and new developments. Curr Opin Oncol. 2008;20(6):676–84.

    Article  PubMed  Google Scholar 

  7. Nolan C, Deangelis LM. Overview of metastatic disease of the central nervous system. Handb Clin Neurol. 2018;149:3–23.

    Article  PubMed  Google Scholar 

  8. Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol. 2004;22(14):2865–72.

    Article  PubMed  Google Scholar 

  9. Berghoff AS, Schur S, Fureder LM, Gatterbauer B, Dieckmann K, Widhalm G, et al. Descriptive statistical analysis of a real life cohort of 2419 patients with brain metastases of solid cancers. ESMO Open. 2016;1(2):e000024.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cagney DN, Martin AM, Catalano PJ, Redig AJ, Lin NU, Lee EQ, et al. Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: a population-based study. Neuro Oncol. 2017;19(11):1511–21.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X, et al. Effect of tumor subtype on survival and the graded prognostic assessment for patients with breast cancer and brain metastases. Int J Radiat Oncol Biol Phys. 2012;82(5):2111–7.

    Article  PubMed  Google Scholar 

  12. Martin AM, Cagney DN, Catalano PJ, Warren LE, Bellon JR, Punglia RS, et al. Brain metastases in newly diagnosed breast cancer: a population-based study. JAMA Oncol. 2017;3(8):1069–77.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hall WA, Djalilian HR, Nussbaum ES, Cho KH. Long-term survival with metastatic cancer to the brain. Med Oncol (Northwood, London, England). 2000;17(4):279–86.

    Article  CAS  Google Scholar 

  14. Yi CA, Shin KM, Lee KS, Kim BT, Kim H, Kwon OJ, et al. Non-small cell lung cancer staging: efficacy comparison of integrated PET/CT versus 3.0-T whole-body MR imaging. Radiology. 2008;248(2):632–42.

    Article  PubMed  Google Scholar 

  15. Millon D, Byl D, Collard P, Cambier SE, Van Maanen AG, Vlassenbroek A, et al. Could new reconstruction CT techniques challenge MRI for the detection of brain metastases in the context of initial lung cancer staging? Eur Radiol. 2018;28(2):770–9.

    Article  PubMed  Google Scholar 

  16. Bochev P, Klisarova A, Kaprelyan A, Chaushev B, Dancheva Z. Brain metastases detectability of routine whole body (18)F-FDG PET and low dose CT scanning in 2502 asymptomatic patients with solid extracranial tumors. Hell J Nucl Med. 2012;15(2):125–9.

    PubMed  Google Scholar 

  17. Deike-Hofmann K, Thunemann D, Breckwoldt MO, Schwarz D, Radbruch A, Enk A, et al. Sensitivity of different MRI sequences in the early detection of melanoma brain metastases. PLoS One. 2018;13(3):e0193946.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Posner JB, Chernik NL. Intracranial metastases from systemic cancer. Adv Neurol. 1978;19:579–92.

    CAS  PubMed  Google Scholar 

  19. Tsukada Y, Fouad A, Pickren JW, Lane WW. Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer. 1983;52(12):2349–54.

    Article  CAS  PubMed  Google Scholar 

  20. Drilon A, Lin JJ, Filleron T, Ni A, Milia J, Bergagnini I, et al. Brief report: frequency of brain metastases and multikinase inhibitor outcomes in patients with RET-rearranged lung cancers. J Thorac Oncol. 2018;13(10):1595–601.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Goncalves PH, Peterson SL, Vigneau FD, Shore RD, Quarshie WO, Islam K, et al. Risk of brain metastases in patients with nonmetastatic lung cancer: analysis of the Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) data. Cancer. 2016;122(12):1921–7.

    Article  PubMed  Google Scholar 

  22. Hsiao SH, Chou YT, Lin SE, Hsu RC, Chung CL, Kao YR, et al. Brain metastases in patients with non-small cell lung cancer: the role of mutated-EGFRs with an exon 19 deletion or L858R point mutation in cancer cell dissemination. Oncotarget. 2017;8(32):53405–18.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hsu F, De Caluwe A, Anderson D, Nichol A, Toriumi T, Ho C. Patterns of spread and prognostic implications of lung cancer metastasis in an era of driver mutations. Curr Oncol. 2017;24(4):228–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Martini N, Bains MS, Burt ME, Zakowski MF, McCormack P, Rusch VW, et al. Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg. 1995;109(1):120–9.

    Article  CAS  PubMed  Google Scholar 

  25. Seute T, Leffers P, ten Velde GP, Twijnstra A. Detection of brain metastases from small cell lung cancer: consequences of changing imaging techniques (CT versus MRI). Cancer. 2008;112(8):1827–34.

    Article  PubMed  Google Scholar 

  26. Wang BX, Ou W, Mao XY, Liu Z, Wu HQ, Wang SY. Impacts of EGFR mutation and EGFR-TKIs on incidence of brain metastases in advanced non-squamous NSCLC. Clin Neurol Neurosurg. 2017;160:96–100.

    Article  PubMed  Google Scholar 

  27. Zhu H, Bi Y, Han A, Luo J, Li M, Shi F, et al. Risk factors for brain metastases in completely resected small cell lung cancer: a retrospective study to identify patients most likely to benefit from prophylactic cranial irradiation. Radiat Oncol (London, England). 2014;9:216.

    Article  Google Scholar 

  28. Yuan R, Yamada A, Weber B, Ho C. Radiographic patterns and survival of patients with early and late brain metastases in EGFR wild type and mutant non small cell lung cancer. J Neurooncol. 2016;127(3):525–33.

    Article  CAS  PubMed  Google Scholar 

  29. Wu AJ, Gillis A, Foster A, Woo K, Zhang Z, Gelblum DY, et al. Patterns of failure in limited-stage small cell lung cancer: Implications of TNM stage for prophylactic cranial irradiation. Radiother Oncol. 2017;125(1):130–5.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Diaz ME, Debowski M, Hukins C, Fielding D, Fong KM, Bettington CS. Non-small cell lung cancer brain metastasis screening in the era of positron emission tomography-CT staging: current practice and outcomes. J Med Imaging Radiat Oncol. 2018;62(3):383–8.

    Article  PubMed  Google Scholar 

  31. Ignatov A, Eggemann H, Burger E, Ignatov T. Patterns of breast cancer relapse in accordance to biological subtype. J Cancer Res Clin Oncol. 2018;144(7):1347–55.

    Article  PubMed  Google Scholar 

  32. Kim YJ, Kim JS, Kim IA. Molecular subtype predicts incidence and prognosis of brain metastasis from breast cancer in SEER database. J Cancer Res Clin Oncol. 2018;144(9):1803–16.

    Article  CAS  PubMed  Google Scholar 

  33. Pelletier EM, Shim B, Goodman S, Amonkar MM. Epidemiology and economic burden of brain metastases among patients with primary breast cancer: results from a US claims data analysis. Breast Cancer Res Treat. 2008;108(2):297–305.

    Article  PubMed  Google Scholar 

  34. Darlix A, Griguolo G, Thezenas S, Kantelhardt E, Thomssen C, Dieci MV, et al. Hormone receptors status: a strong determinant of the kinetics of brain metastases occurrence compared with HER2 status in breast cancer. J Neurooncol. 2018;138(2):369–82.

    Article  CAS  PubMed  Google Scholar 

  35. Kennecke H, Yerushalmi R, Woods R, Cheang MC, Voduc D, Speers CH, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010;28(20):3271–7.

    Article  PubMed  Google Scholar 

  36. Soni A, Ren Z, Hameed O, Chanda D, Morgan CJ, Siegal GP, et al. Breast cancer subtypes predispose the site of distant metastases. Am J Clin Pathol. 2015;143(4):471–8.

    Article  PubMed  Google Scholar 

  37. Jin J, Gao Y, Zhang J, Wang L, Wang B, Cao J, et al. Incidence, pattern and prognosis of brain metastases in patients with metastatic triple negative breast cancer. BMC Cancer. 2018;18(1):446.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kyeong S, Cha YJ, Ahn SG, Suh SH, Son EJ, Ahn SJ. Subtypes of breast cancer show different spatial distributions of brain metastases. PLoS One. 2017;12(11):e0188542.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Suki D. The epidemiology of brain metastasis. Malden: Futura, Blackwell Publishing; 2004. p. 20–34.

    Google Scholar 

  40. Samlowski WE, Moon J, Witter M, Atkins MB, Kirkwood JM, Othus M, et al. High frequency of brain metastases after adjuvant therapy for high-risk melanoma. Cancer Med. 2017;6(11):2576–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Sampson JH, Carter JH, Jr., Friedman AH, Seigler HF. Demographics, prognosis, and therapy in 702 patients with brain metastases from malignant melanoma. J Neurosurg 1998;88(1):11–20.

    Article  CAS  PubMed  Google Scholar 

  42. Massard C, Zonierek J, Gross-Goupil M, Fizazi K, Szczylik C, Escudier B. Incidence of brain metastases in renal cell carcinoma treated with sorafenib. Ann Oncol. 2010;21(5):1027–31.

    Article  CAS  PubMed  Google Scholar 

  43. Dudek AZ, Raza A, Chi M, Singhal M, Oberoi R, Mittapalli RK, et al. Brain metastases from renal cell carcinoma in the era of tyrosine kinase inhibitors. Clin Genitourin Cancer. 2013;11(2):155–60.

    Article  PubMed  Google Scholar 

  44. Hanzly M, Abbotoy D, Creighton T, Diorio G, Mehedint D, Murekeyisoni C, et al. Early identification of asymptomatic brain metastases from renal cell carcinoma. Clin Exp Metastasis. 2015;32(8):783–8.

    Article  PubMed  Google Scholar 

  45. Marshall ME, Pearson T, Simpson W, Butler K, McRoberts W. Low incidence of asymptomatic brain metastases in patients with renal cell carcinoma. Urology. 1990;36(4):300–2.

    Article  CAS  PubMed  Google Scholar 

  46. Shuch B, La Rochelle JC, Klatte T, Riggs SB, Liu W, Kabbinavar FF, et al. Brain metastasis from renal cell carcinoma: presentation, recurrence, and survival. Cancer. 2008;113(7):1641–8.

    Article  PubMed  Google Scholar 

  47. Sivaramakrishna B, Gupta NP, Wadhwa P, Hemal AK, Dogra PN, Seth A, et al. Pattern of metastases in renal cell carcinoma: a single institution study. Indian J Cancer. 2005;42(4):173–7.

    CAS  PubMed  Google Scholar 

  48. Vanhuyse M, Penel N, Caty A, Fumagalli I, Alt M, Zini L, et al. Do anti-angiogenic therapies prevent brain metastases in advanced renal cell carcinoma? Bull Cancer. 2012;99(12):100–6.

    Article  PubMed  Google Scholar 

  49. Sun M, De Velasco G, Brastianos PK, Aizer AA, Martin A, Moreira R, et al. The development of brain metastases in patients with renal cell carcinoma: epidemiologic trends, survival, and clinical risk factors using a population-based cohort. Eur Urol Focus. 2019;5(3):474–81.

    Article  PubMed  Google Scholar 

  50. Christensen TD, Palshof JA, Larsen FO, Hogdall E, Poulsen TS, Pfeiffer P, et al. Risk factors for brain metastases in patients with metastatic colorectal cancer. Acta Oncol (Stockholm, Sweden). 2017;56(5):639–45.

    Article  Google Scholar 

  51. Jiang XB, Yang QY, Sai K, Zhang XH, Chen ZP, Mou YG. Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center. Tumour Biol. 2011;32(6):1249–56.

    Article  CAS  PubMed  Google Scholar 

  52. Kim DY, Ryu CG, Jung EJ, Paik JH, Hwang DY. Brain metastasis from colorectal cancer: a single center experience. Ann Surg Treat Res. 2018;94(1):13–8.

    Article  PubMed  Google Scholar 

  53. Mongan JP, Fadul CE, Cole BF, Zaki BI, Suriawinata AA, Ripple GH, et al. Brain metastases from colorectal cancer: risk factors, incidence, and the possible role of chemokines. Clin Colorectal Cancer. 2009;8(2):100–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Qiu M, Hu J, Yang D, Cosgrove DP, Xu R. Pattern of distant metastases in colorectal cancer: a SEER based study. Oncotarget. 2015;6(36):38658–66.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Ali MA, Hirshman BR, Wilson B, Carroll KT, Proudfoot JA, Goetsch SJ, et al. Survival patterns of 5750 stereotactic radiosurgery-treated patients with brain metastasis as a function of the number of lesions. World Neurosurg. 2017;107:944–51.e1.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Bartelt S, Lutterbach J. Brain metastases in patients with cancer of unknown primary. J Neurooncol. 2003;64(3):249–53.

    Article  PubMed  Google Scholar 

  57. Brogi E, Murphy CG, Johnson ML, Conlin AK, Hsu M, Patil S, et al. Breast carcinoma with brain metastases: clinical analysis and immunoprofile on tissue microarrays. Ann Oncol. 2011;22(12):2597–603.

    Article  CAS  PubMed  Google Scholar 

  58. Farris M, McTyre ER, Cramer CK, Hughes R, Randolph DM 2nd, Ayala-Peacock DN, et al. Brain metastasis velocity: a novel prognostic metric predictive of overall survival and freedom from whole-brain radiation therapy after distant brain failure following upfront radiosurgery alone. Int J Radiat Oncol Biol Phys. 2017;98(1):131–41.

    Article  PubMed  Google Scholar 

  59. Lentzsch S, Reichardt P, Weber F, Budach V, Dorken B. Brain metastases in breast cancer: prognostic factors and management. Eur J Cancer (Oxford, England : 1990). 1999;35(4):580–5.

    Article  CAS  Google Scholar 

  60. Sahgal A, Aoyama H, Kocher M, Neupane B, Collette S, Tago M, et al. Phase 3 trials of stereotactic radiosurgery with or without whole-brain radiation therapy for 1 to 4 brain metastases: individual patient data meta-analysis. Int J Radiat Oncol Biol Phys. 2015;91(4):710–7.

    Article  PubMed  Google Scholar 

  61. Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, Wasserman T, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37(4):745–51.

    Article  CAS  PubMed  Google Scholar 

  62. Gaspar LE, Scott C, Murray K, Curran W. Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases. Int J Radiat Oncol Biol Phys. 2000;47(4):1001–6.

    Article  CAS  PubMed  Google Scholar 

  63. Nieder C, Nestle U, Motaref B, Walter K, Niewald M, Schnabel K. Prognostic factors in brain metastases: should patients be selected for aggressive treatment according to recursive partitioning analysis (RPA) classes? Int J Radiat Oncol Biol Phys. 2000;46(2):297–302.

    Article  CAS  PubMed  Google Scholar 

  64. Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC.3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049–60.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, Baumert BG, et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol. 2011;29(2):134–41.

    Article  PubMed  Google Scholar 

  66. Loh D, Hogg F, Edwards P, MacColl J, Brogna C, Bhangoo R, et al. Two-year experience of multi-disciplinary team (MDT) outcomes for brain metastases in a tertiary neuro-oncology centre. Br J Neurosurg. 2018;32(1):53–60.

    Article  PubMed  Google Scholar 

  67. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494–500.

    Article  CAS  PubMed  Google Scholar 

  68. Nieder C, Geinitz H, Molls M. Validation of the graded prognostic assessment index for surgically treated patients with brain metastases. Anticancer Res. 2008;28(5b):3015–7.

    PubMed  Google Scholar 

  69. Nieder C, Mehta MP. Prognostic indices for brain metastases—usefulness and challenges. Radiat Oncol (London, England). 2009;4:10.

    Article  Google Scholar 

  70. Sperduto PW, Chao ST, Sneed PK, Luo X, Suh J, Roberge D, et al. Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys. 2010;77(3):655–61.

    Article  PubMed  Google Scholar 

  71. Laakmann E, Witzel I, Scriba V, Grzyska U, Zu Eulenburg C, Burchardi N, et al. Radiological patterns of brain metastases in breast cancer patients: a subproject of the German Brain Metastases in Breast Cancer (BMBC) Registry. Int J Mol Sci. 2016;17(10):1615.

    Article  PubMed Central  Google Scholar 

  72. Sperduto PW, Jiang W, Brown PD, Braunstein S, Sneed P, Wattson DA, et al. The prognostic value of BRAF, C-KIT, and NRAS mutations in melanoma patients with brain metastases. Int J Radiat Oncol Biol Phys. 2017;98(5):1069–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Chiang JM, Hsieh PS, Chen JS, Tang R, You JF, Yeh CY. Rectal cancer level significantly affects rates and patterns of distant metastases among rectal cancer patients post curative-intent surgery without neoadjuvant therapy. World J Surg Oncol. 2014;12:197.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Michl M, Thurmaier J, Schubert-Fritschle G, Wiedemann M, Laubender RP, Nussler NC, et al. Brain metastasis in colorectal cancer patients: survival and analysis of prognostic factors. Clin Colorectal Cancer. 2015;14(4):281–90.

    Article  PubMed  Google Scholar 

  75. Kromer C, Xu J, Ostrom QT, Gittleman H, Kruchko C, Sawaya R, et al. Estimating the annual frequency of synchronous brain metastasis in the United States 2010–2013: a population-based study. J Neurooncol. 2017;134(1):55–64.

    Article  PubMed  Google Scholar 

  76. Viadana E, Bross ID, Pickren JW. The relationship of histology to the spread of cancer. J Surg Oncol. 1975;7(3):177–86.

    Article  CAS  PubMed  Google Scholar 

  77. Fidler IJ. The pathogenesis of cancer metastasis: the ‘seed and soil’ hypothesis revisited. Nat Rev Cancer. 2003;3(6):453–8.

    Article  CAS  PubMed  Google Scholar 

  78. Bos PD, Zhang XH, Nadal C, Shu W, Gomis RR, Nguyen DX, et al. Genes that mediate breast cancer metastasis to the brain. Nature. 2009;459(7249):1005–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Nguyen DX, Chiang AC, Zhang XH, Kim JY, Kris MG, Ladanyi M, et al. WNT/TCF signaling through LEF1 and HOXB9 mediates lung adenocarcinoma metastasis. Cell. 2009;138(1):51–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Yau T, Swanton C, Chua S, Sue A, Walsh G, Rostom A, et al. Incidence, pattern and timing of brain metastases among patients with advanced breast cancer treated with trastuzumab. Acta Oncol. 2006;45(2):196–201.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

    Linda Dirven & Martin J. B. Taphoorn

  2. Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands

    Linda Dirven & Martin J. B. Taphoorn

Authors
  1. Linda Dirven
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin J. B. Taphoorn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linda Dirven .

Editor information

Editors and Affiliations

  1. Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Manmeet Ahluwalia

  2. Department of Neurosurgery and Neuro-Oncology, Clairval Hospital Center, Ramsay-Générale de Santé, Marseille, France, Neurophysiopathology Institute, Aix-Marseille Université, Marseille, France

    Philippe Metellus

  3. Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy

    Riccardo Soffietti

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dirven, L., Taphoorn, M.J.B. (2020). Epidemiology of Central Nervous System Metastases. In: Ahluwalia, M., Metellus, P., Soffietti, R. (eds) Central Nervous System Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-23417-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-23417-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23416-4

  • Online ISBN: 978-3-030-23417-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation