Evidence map›Paper›PMID 42608496›Full record

ArticleJournal of neuro-oncology2026

Treatment selection and functional outcomes in motor cortex metastases.

Luisa Mona Kraus, Maria Goldberg, Paul Simon Backhaus, Carolin Albrecht, Denise Bernhardt, Stephanie E Combs, Chiara Negwer, Bernhard Meyer, Arthur Wagner

Abstract read
In one paragraph

Article in Journal of neuro-oncology, 2026. 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

9 authors.

Luisa Mona KrausDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany. luisamona.kraus@mri.tum.de.ORCID https://orcid.org/0000-0002-2282-8744
Maria GoldbergDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Paul Simon BackhausDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Carolin AlbrechtDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Denise BernhardtDepartment of Radiation Oncology, University Hospital of Technical University Munich, School of Medicine and Health, Munich, Germany.
Stephanie E CombsDepartment of Radiation Oncology, University Hospital of Technical University Munich, School of Medicine and Health, Munich, Germany.
Chiara NegwerDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Bernhard MeyerDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
Arthur WagnerDepartment of Neurosurgery, University Hospital of Technical University Munich, School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBrain metastases are associated with a poor prognosis. While systemic therapy primarily determines overall survival, surgical cytoreduction may improve local disease control. Preserving neurological function and independence is particularly important in patients with limited life expectancy. However, surgery is often avoided for metastases located in eloquent brain regions. This study evaluates treatment selection and functional outcomes in patients with metastases involving the primary motor cortex.

methodsWe conducted a retrospective single-center analysis of patients treated for central motor eloquent brain metastases. Primary endpoints were motor function and KPS at discharge and at 6-month FU. Neurological change was categorized as improvement, stability, or deterioration in Medical Research Council (MRC) grade. Secondary variables included intracranial tumor burden, extracranial disease, prior systemic therapy, disease duration, which were used for risk stratification. Comparative analyses were performed using Wilcoxon rank-sum test, Fisher's exact test, multivariable logistic, and Firth regression.

resultsA total of 152 patients (79 male, 73 female; mean age 65.5 years) were eligible. Treatment comprised primary surgery in 109 patients, definitive stereotactic radiotherapy in 24, salvage surgery after radiotherapy in 17, and best supportive care in two. In single metastases with higher volume surgery was favored, whereas extracranial disease, prior systemic therapy, and longer disease duration were associated with allocation to radiotherapy. At discharge improvement rate was 13% (MSR) versus 25% (SRT) (p = 0.400), at 6-month FU improvement was 45% in the MSR and 9% in the SRT cohort (p = 0.063), while longitudinal analysis showed significant improvement in median MRC grade only in the surgery cohort.

conclusionSurgery was not associated with inferior functional outcomes and even resulted in greater motor improvement at FU. These findings support surgery as a feasible treatment option, including for selected high-risk patients, while stereotactic radiotherapy seems to remain an important alternative for frailer patients with longer disease histories.

Indexed as

Brain NeoplasmsMotor CortexRadiosurgeryAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSalvage TherapyTreatment OutcomeBrain metastasesMicrosurgical resectionMotor cortexStereotactic radiosurgery

Identifiers

PMID42608496
PMCPMC13481405

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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.