Evidence map›Paper›PMID 39467853›Full record

ArticleNeurosurgical review2024

The role of surgery in recurrent local cerebral metastases: a multi-institutional retrospective analysis.

Stefano Telera, Luigino Tosatto, Roberto Colasanti, Andrea Pace, Veronica Villani, Fabrizio Rasile, Mario Lecce, Francesco Crispo, Laura Marucci, Alessia Farneti and 5 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Radiotherapeutic management of brain metastases in patients with breast cancer: a narrative review.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Stefano TeleraUOSD Neurosurgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy. stefano.telera@ifo.it.ORCID http://orcid.org/0000-0002-1239-7143
Luigino TosattoUOC Neurosurgery, M. Bufalini Hospital, Cesena, Italy.
Roberto ColasantiUOC Neurosurgery, M. Bufalini Hospital, Cesena, Italy.
Andrea PaceUOSD Neuro-Oncology, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Veronica VillaniUOSD Neuro-Oncology, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Fabrizio RasileUOSD Neurosurgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Mario LecceUOSD Neurosurgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Francesco CrispoUOSD Neurosurgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Laura MarucciUOC Radiotherapy, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Alessia FarnetiUOC Radiotherapy, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Mariantonia CarosiUOC Pathology, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Mariangela NovelloUOC Pathology, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Francesca Romana GiordanoUOC Anesthesiology and Intensive Care, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Isabella SperdutiUOC Biostatistics, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.
Roberto GazzeriUOC Pain Therapy, San Giovanni Addolorata Hospital, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLocal recurrent brain metastases are defined as lesions that recur in the brain at the same site after a previous local therapy. In patients already submitted to surgery, a second operation may be potentially challenging due to scar formation, infiltration of cerebral vessels or eloquent brain areas and local effect of previous radiotherapy. The aim of this study is to retrospectively review the results and complications of a second surgical treatment in a series of local recurrent lesions and to review the literature on this topic.

methods37 patients submitted to surgery for a local, histologically confirmed, recurrent brain metastases between 2000 and 2022 were retrospectively analyzed with respect to the following parameters: age, histology, anatomic location, time to recurrence, previous radiotherapy, size of recurrent tumors, preoperative and postoperative Karnofsky Performance Status (KPS) score, recursive partitioning analysis (RPA) class and graded prognostic assessment (GPA) score, surgery-related complications and the presence of further cerebral metastases. Overall survival (OS) was calculated using the Kaplan-Meier method. A multivariate Cox proportional hazard model was developed using stepwise regression (forwards selection) with predictive variables that were significant in the univariate analyses.

resultsA significant improvement of post-operative KPS status was obtained after second surgery. At multivariate analysis better results in terms of OS were achieved in patients with a pre-operative KPS ≥ 70 and in patients who had received radiotherapy after the initial surgery. No significant postoperative complications related to previous treatments were observed.

conclusionsSurgical resection of local recurrent brain metastases may improve patients ́ neurologic conditions allowing more time for systemic therapies to act with a low incidence of surgery-related morbidity and mortality. However, careful patient selection with a fair pre-operative clinical status seems mandatory to achieve the best post-operative results, since uniform treatment-paradigms cannot be established yet, due to the highly heterogeneous patient cohort.

Indexed as

Brain NeoplasmsNeoplasm Recurrence, LocalAdultAgedFemaleHumansKaplan-Meier EstimateKarnofsky Performance StatusMaleMiddle AgedNeurosurgical ProceduresPostoperative ComplicationsRetrospective StudiesTreatment OutcomeBrain metastasesLocal recurrenceRadiotherapySurgery

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.