ArticleDiscover oncology2025
Surgical outcomes and prognostic factors in 228 patients with brain metastases: a focus on en bloc resection and multimodal therapy.
Article in Discover oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Baseline Graded Prognostic Assessment Is Associated with Postoperative Health-Related Quality of Life Recovery After Brain Metastasis Resection: A Prospective Cohort Study.Journal of clinical medicine · 2026Article
- Predicting Postoperative Complications in Lung Cancer Spinal Metastases: A Nomogram Based on Nutritional, Low Psoas Muscle Index, and Functional Status.Current oncology (Toronto, Ont.) · 2026Article
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Authors and funding
7 authors.
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Abstract
objectivesThis study aimed to evaluate the survival outcomes and identify prognostic factors in patients undergoing surgical resection for brain metastases (BMs), with a particular focus on the impact of surgical techniques and multimodal therapy sequences.
methodsWe conducted a retrospective analysis of 228 consecutive patients who underwent neurosurgical resection for BMs at a single institution (2012–2020). Primary endpoints were median overall survival (mOS) and survival rates, analyzed via Kaplan-Meier methodology. Prognostic factors were assessed using univariate and multivariate Cox proportional hazards models, with subgroup analyses based on primary tumor origin.
resultsThe cohort’s overall mOS was 14 months, with 1-, 2-, and 3-year survival rates of 60.3%, 35.4%, and 23.2%, respectively. Multivariate analysis identified preoperative Karnofsky Performance Status (KPS) as a powerful independent prognostic factor (Hazard Ratio [HR] = 49.076, 95% Confidence Interval [CI]: 21.483–112.110, P < 0.001). The treatment modality significantly influenced survival: patients receiving postoperative radiotherapy achieved an mOS of 18 months, compared to 13 months for surgery alone. Strikingly, the cohort receiving combined pre- and postoperative radiotherapy (n = 6) demonstrated a superior mOS of 41 months. In lung cancer BMs (n = 109, mOS = 11 months), targeted therapy was associated with a significantly prolonged mOS of 28 months versus 10 months in non-recipients. For breast cancer BMs (n = 26, mOS = 17 months), chemotherapy was an independent favorable prognostic factor (HR = 6.297, P = 0.009).
conclusionsSurgical resection, particularly when integrated into a multimodal strategy, confers significant survival benefits for patients with BMs. The sequence of therapy is critical, with combined perioperative radiotherapy emerging as a highly promising regimen. Preoperative KPS is a paramount prognosticator. These findings advocate for an aggressive, personalized surgical approach embedded within a comprehensive neuro-oncological framework.
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