Evidence map›Paper›PMID 41430011›Full record

ArticleJournal of neuro-oncology2025

Postoperative absence of residual intracranial tumor volume is associated with improved survival and intracranial disease control in non-small cell lung cancer brain metastases.

Jacopo Bellomo, Meltem Gönel, Jonathan Sutter, Anna Maria Zeitlberger, Maria Nikolaeva, Tristan Schmidlechner, Vittorio Stumpo, Luis Padevit, Victor Egon Staartjes, Flavio Vasella and 10 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

20 authors.

Jacopo Bellomo *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Meltem Gönel *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Jonathan Sutter *Department of Neurosurgery, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Anna Maria ZeitlbergerDepartment of Neurosurgery, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Maria NikolaevaDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Tristan SchmidlechnerDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Vittorio StumpoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Luis PadevitDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Victor Egon StaartjesDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Flavio VasellaDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Jorn FierstraDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Nicolin HaincDepartment of Neuroradiology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
Isabelle OpitzDepartment of Thoracic Surgery, University Hospital and University of Zurich, Zurich, Switzerland.
Michael WellerDepartment of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
Emilie Le RhunDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Oliver BozinovDepartment of Neurosurgery, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Luca RegliDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Carlo SerraDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Marian Christoph NeidertDepartment of Neurosurgery, HOCH Health Ostschweiz, St. Gallen, Switzerland.
Stefanos VoglisDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland. stefanos.voglis@usz.ch.ORCID http://orcid.org/0000-0002-1514-1442

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBrain metastases (BM) from non-small cell lung cancer (NSCLC) are associated with limited prognosis. Although surgical resection is part of multimodal management, the prognostic relevance of surgical intracranial tumor load reduction in the era of stereotactic radiotherapy and modern systemic therapies remains unclear.

methodsThis retrospective bicentric cohort study included 285 adults with histologically confirmed NSCLC who underwent BM resection. Pre- and postoperative MRI were used for volumetric assessment. Gross-total resection (GTR) was defined as the absence of measurable postoperative residual volume (RV). Outcomes were overall survival (OS) and intracranial progression-free survival (iPFS). Multivariable Cox regression models adjusted for age, preoperative performance status, extracranial metastases, number of BM, and postoperative radiotherapy and systemic therapies.

resultsMedian OS was 14.3 months and median iPFS was 8.0 months. GTR was achieved in 96 patients (34% overall; 38% of patients with evaluable volumetric imaging) and was independently associated with longer OS (adjusted HR, 0.51; 95% CI, 0.30-0.86) and prolonged iPFS (adjusted HR, 0.55; 95% CI, 0.31-0.99). Postoperative RV, analyzed continuously or categorically, showed no consistent association with OS or iPFS. The benefit of GTR was most pronounced in patients with single BM or without extracranial metastases.

conclusionAchieving complete intracranial tumor resection, rather than the amount of postoperative residual volume, was consistently associated with improved survival and intracranial disease control. These findings support the clinical relevance of GTR in selected NSCLC-BM patients and may inform patient counselling and surgical decision-making, while warranting further investigation in patients with multifocal but safely resectable intracranial disease.

Indexed as

Brain NeoplasmsCarcinoma, Non-Small-Cell LungLung NeoplasmsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasm, ResidualPrognosisRetrospective StudiesSurvival RateBrain metastasisExtent of resectionImmunotherapyLung cancerOverall survivalProgression-free survivalResidual tumorTargeted therapy

Identifiers

PMID41430011
PMCPMC12722344

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