Annals of Surgical Oncology

, Volume 1, Issue 2, pp 169–178 | Cite as

Management of metastatic brain tumors

  • Raymond Sawaya
  • B. Lee Ligon
  • Rajesh K. Bindal
Educational Review


Background: Brain metastases are the most common neurological complication of systemic cancer. They represent a serious cause of morbidity and mortality and a significant challenge for neurosurgeons. They outnumber all other intracranial tumors combined and, with advances in technology and treatment of systemic cancer, are on the increase as cancer patients live longer.

Methods: We have reviewed the major factors that influence the occurrences of metastases in the central nervous system: primary cancer, patient age and sex, clinical aspects of presentation, basic diagnostic modalities, diagnostic imaging (computed tomography and magnetic resonance imaging), and treatment considerations. In discussing these different aspects, we emphasize the efficacy of different treatment options, including recent information regarding multiple metastases that broadens the scope of surgical implications. The criteria we present are directed toward considerations made by general surgeons, as well as those made by neurosurgeons.

Conclusions: Although radiotherapy remains the main therapeutic modality, surgical excision has increasingly shown advantages in certain settings, as has stereotactic radiosurgery. Chemotherapy is less effective, but its advantages are reviewed, as are the implications of recurrent metastases.

Key Words

Brain metastasis Brain neoplasms Multiple brain metastases Metastatic brain tumors 


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Copyright information

© The Society of Surgical Oncology, Inc. 1994

Authors and Affiliations

  • Raymond Sawaya
    • 1
  • B. Lee Ligon
    • 1
  • Rajesh K. Bindal
    • 1
  1. 1.Department of Neurosurgery, Division of SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonUSA

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