ArticleActa neurochirurgica2025
Prognostic factors after salvage resection for local progression of brain metastases after radiotherapy.
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment modalities in recurrent brain metastases: a combined institutional and individual patient data meta-analysis of post-recurrence survival and local progression-free survival.Journal of neuro-oncology · 2025Pooled it
- Review
- The threefold value of surgery in previously irradiated brain metastases.Journal of neuro-oncology · 2026Article
- A Comprehensive Analysis of the Management of Brain Metastases-Experience from a South-Eastern European Neurosurgical Centre.Medicina (Kaunas, Lithuania) · 2025Article
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10 authors.
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Abstract
backgroundRecent advances in cancer treatment have prolonged survival after the onset of brain metastasis (BM), increasing the incidence of local progression (LP) following radiotherapy. However, no standard approach exists for managing LP. We aimed to evaluate the outcomes of salvage surgery in a clinical setting.
methodsThe clinical data were retrospectively collected from the medical records of 49 patients who underwent their first salvage surgery for LP of BM at a single institution between April 2014 and March 2024. Overall survival (OS) and LP-free survival (LPFS) were evaluated using the Kaplan-Meier method.
resultsMost patients (47/49, 96%) had a history of stereotactic radiosurgery (n = 34) and/or stereotactic radiotherapy (n = 14). The histopathological examination of surgical specimens confirmed tumor recurrence in 33 patients and radiation necrosis (RN) in 16 patients. The interval from prior radiotherapy to salvage surgery was longer in patients with RN than in those with recurrence (median: 42.3 vs. 9.3 months, respectively). OS was longer in the RN group compared with the recurrent group (median: 68.5 months and 21.8 months, respectively). In the recurrent group, shorter OS was associated with preoperative poor KPS (< 70), the presence of active extracranial lesions, and RPA classes 2-3. The extent of resection, postoperative chemotherapy, and local irradiation had no significant effect on OS. After salvage surgery, further LP was observed in 20 patients (61%), with a median LPFS of 7.0 months in the recurrent group. No significant association was found between LPFS and the extent of tumor removal, postoperative chemotherapy, and RT.
conclusionsThis study highlights a relatively prolonged survival period following salvage surgery for local progression of BM after irradiation. Salvage surgery is a treatment option in patients with good extracranial control and performance status. The high recurrence rate following salvage treatment underscores the need for developing additional treatment approaches.
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