Neurological Sciences

, Volume 39, Issue 4, pp 671–677 | Cite as

Multiple brain metastases: a surgical series and neurosurgical perspective

  • Maurizio Salvati
  • Maria Pia Tropeano
  • Vincenza Maiola
  • Laura Lavalle
  • Christian Brogna
  • Claudio Colonnese
  • Alessandro Frati
  • Alessandro D’Elia
Original Article
  • 104 Downloads

Abstract

Despite review papers claim for radical treatment of oligometastatic patients, only few surgical series have been published. In this study, we analyze results and actual role of surgical resection for the management of patients with multiple brain metastases. This retrospective study compares surgical results of two groups of patients consecutively treated in our Institute from January 2004 to June 2015. The first group comprises all 32 patients with multiple brain metastases with only 2–3 lesions who underwent surgical resection of all lesions; the second group comprises 30 patients with a single surgically treated brain mestastasis compatible with the first group (match-paired control series). Median survival was 14.6 months for patients with multiple brain metastases (range 1–28 months) and 17.4 months for patients with a single brain metastasis (range 4–38 months); the difference was not statistically significant (P = 0.2). Neurological condition improved in 59.4% of patients with multiple metastases, it remained unchanged in 37.5% and worsened in 3.1%. In our series, selected patients with only 2–3 lesions with well-controlled systemic disease, life expectancy of more than 3 months, Karnofsky’s performance status > 60, and surgically accessible lesions, benefited from surgical treatment in terms of survival and quality of life, with reduction or disappearance of significant neurological deficits. The prognosis for these patients is similar to that of patients with a single metastasis. It seems that patients with breast cancer included in our series had the worst prognosis if compared to other histotypes.

Keywords

Brain metastases Oligometastases Surgery Neurosurgery RPA classes 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.DAI Neurology and Psychiatry, Department of Neurosurgery, Policlinico Umberto ISapienza University of RomeRomeItaly
  2. 2.Neuroscience DepartmentUniversity of SienaSienaItaly
  3. 3.Clinical Fellow NeurosurgeryKing’s College HospitalLondonUK
  4. 4.DAI Neurology and Psichiatry, Department of Neuroradiology, Policlinico Umberto ISapienza University of RomeRomeItaly
  5. 5.Neurosurgery DepartmentIRCCS NEUROMED INM, NeurochirurgiaPozzilliItaly

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