Cancer Medicine (Nov 2019)

Operative and peri‐operative considerations in the management of brain metastasis

  • Eric W. Sankey,
  • Vadim Tsvankin,
  • Matthew M. Grabowski,
  • Gautam Nayar,
  • Kristen A. Batich,
  • Aida Risman,
  • Cosette D. Champion,
  • April K. S. Salama,
  • C. Rory Goodwin,
  • Peter E. Fecci

DOI
https://doi.org/10.1002/cam4.2577
Journal volume & issue
Vol. 8, no. 16
pp. 6809 – 6831

Abstract

Read online

Abstract The number of patients who develop metastatic brain lesions is increasing as the diagnosis and treatment of systemic cancers continues to improve, resulting in longer patient survival. The role of surgery in the management of brain metastasis (BM), particularly multiple and recurrent metastases, remains controversial and continues to evolve. However, with appropriate patient selection, outcomes after surgery are typically favorable. In addition, surgery is the only means to obtain a tissue diagnosis and is the only effective treatment modality to quickly relieve neurological complications or life‐threatening symptoms related to significant mass effect, CSF obstruction, and peritumoral edema. As such, a thorough understanding of the role of surgery in patients with metastatic brain lesions, as well as the factors associated with surgical outcomes, is essential for the effective management of this unique and growing patient population.

Keywords