Abstract
The authors report their 27-year experience regarding 35 cases of supratentorial brain metastasis from sarcoma treated in a single institution: these included ten osteosarcomas, seven leiomyosarcomas, five Ewing sarcomas, four malignant fibrous histiocytomas, three alveolar soft-part sarcomas (ASPS), two rhabdomyosarcomas, one liposarcoma, and three unclassified sarcomas. The first 15 cases of the series have already been described in a previous publication. Median survival after craniotomy was 9.8 months (range: 4–24). In patients with preoperative Karnofsky performance score (KPS) > 60 it was 12.8 months (range: 6.5–24 months) versus 5.4 months for those patients with a KPS ≤ 60 (P = 0.01). Eight patients had more than one lesion, six of which were treated in the last ten years. Of the three patients with ASPS, the first two were alive at 15 and 20 months (before being lost to follow-up) whereas the third patient is alive at 24 month follow-up. The authors conclude that surgery is more effective in treating selected patients with sarcoma metastatic to the brain, and that patients with metastasis from ASPS have good prognosis when submitted to surgical treatment. The complete removal of all brain metastases “en bloc” and a KPS > 60 are associated with the best prognosis. Finally, it seems that surgical indications for multiple brain metastases from sarcoma have increased during the last ten years.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Norden AD, Wen PY, Kesari S (2005) Brain metastases. Curr Opin Neurol 18:654–661
Bindal RK, Sawaya RE, Leavens ME, Taylor SH, Guinee VF (1994) Sarcoma metastatic to the brain: results of surgical treatment. Neurosurgery 35:185–191
Espat NJ, Bilsky M, Lewis JJ, Leung D, Brennan MF (2002) Soft tissue sarcoma brain metastases. Prevalence in a cohort of 3829 patients. Cancer 94:2706–2711
Salvati M, Cervoni L, Caruso R, Gagliardi FM, Delfini R (1998) Sarcoma metastatic to the brain: a series of 15 cases. Surg Neurol 49:441–444
Wronski M, Arbit E, Burt M, Perino G, Galicich JH, Brennan MF (1995) Resection of brain metastases from sarcoma. Ann Surg Oncol 2:392–399
Yoshida S, Morii K, Watanabe M, Saito T (2000) Brain metastasis in patients with sarcoma: an analysis of histological subtypes, clinical characteristics, and outcomes. Surg Neurol 54:160–164
Fox B, Patel A, Suki D, Rao G (2009) Surgical management of metastatic sarcoma to the brain. J Neurosurg 110:181–186
Sawaya R (ed) (2004) Intracranial metastases—chapter 23. Futura Blackwell, Oxford, UK
Gercovic FG, Luna MA, Gottlieb JA (1975) Increased incidence of cerebral metastases in sarcoma patients with prolonged survival from chemotherapy. Report of cases of leiomyosarcoma and chondrosarcoma. Cancer 36:1843–1851
Chang EL, Selek U, Hassenbusch SJ III et al (2005) Outcome variation among “radioresistant” brain metastases treated with stereotactic radiosurgery. Neurosurgery 56:936–945
Lewis AJ (1988) Sarcoma metastatic to the brain. Cancer 61:593–601
Ogose A, Morita T, Hotta T et al (1999) Brain metastases in musculoskeletal sarcomas. Jpn J Clin Oncol 29:245–247
Bindal RK, Sawaya R, Leavens ME et al (1993) Surgical treatment of multiple brain metastases. J Neurosurg 79:210–216
Ordonez NG, Mackay B (1998) Alveolar soft-part sarcoma: a review of the pathology and histogenesis. Ultrastruct Pathol 22:275–292
Bryant BM, Wiltshaw E (1980) Central nervous system involvement in sarcoma. Eur J Cancer 16:1503–1507
Evans HL (1985) Alveolar soft-part sarcoma: a study of 13 typical examples and one with histologically atypical component. Cancer 55:912–917
Auerbach HE, Brooks JJ (1987) Alveolar soft-part sarcoma: a clinicopathologic and immunohistochemical study. Cancer 60:66–73
Wang CH, Lee N, Lee LS (1995) Successful treatment for solitary brain metastasis from alveolar soft part sarcoma. J Neurooncol 25:161–166
Reichardt P, Lindner T, Pink D et al (2003) Chemotherapy in soft-part sarcomas. What do we know? Eur J Cancer 39:1511–1516
Krasin MJ, Davidoff AM, Xiong X, Wu S, Hua C-H, Navid F, Rodriguez-Galindo C, Rao BN, Hoth KA, Neel MD, Merchant TE, Kun LE, Spunt SL (2009) Preliminary results from a prospective study using limited margin radiotherapy in pediatric and young adult patients with high grade nonrhabdomyosarcoma soft-tissue sarcoma. Int J Radiat Oncol Biol Phys. doi:10.1016/j.ijrobp.2009.02.074
Al-Shamy G, Sawaya R (2009) Management of brain metastases: the indispensable role of surgery. J Neurooncol 92(3):275–282
Black PM, Johnson MD (2004) Surgical resection for patients with solid brain metastases: current status. J Neurooncol 69(1–3):119–124
Modha A, Shopard SR, Gutin PH (2005) Surgery of brain metastases—is there still a place for it? J Neurooncol 75(1):21–29
Paek SH, Audu PB, Sperling MR, Cho J, Andrews DW (2005) Reevaluation of surgery for the treatment of brain metastases: review of 208 patients with single or multiple brain metastases treated at one institution with modern neurosurgical techniques. Neurosurgery 56:1021–1034
Suh JH, Chao ST, Vogelbaum MA (2009) Management of brain metastases. Curr Neurol Neurosci Rep 9(3):223–230
Brown PD, Brown C, Pollock B, Gorman D, Foote R (2002) Stereotactic radiosurgery for patients with “radioresistant” brain metastases. Neurosurgery 51:656–667
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Salvati, M., D’Elia, A., Frati, A. et al. Sarcoma metastatic to the brain: a series of 35 cases and considerations from 27 years of experience. J Neurooncol 98, 373–377 (2010). https://doi.org/10.1007/s11060-009-0085-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11060-009-0085-0