Mingtao Feng#, Changshuai Zhou#, Huanhaun Cui, Yang Gao and Yiqun Cao*
Department of Neurosurgery, Fudan University Shanghai Cancer Center, China
#These authors contributed equally to the work
Objective: The traditional view is that patients with Brain Metastases (BMs) are in the end stage and can only receive palliative treatment. However, modern treatment has greatly changed their survival prognosis. The purpose of our study is to determine the curative effect of surgical treatment in patients with different primary tumor brain metastases, and to study the factors influencing the prognosis. Methods: Continuous retrospective analysis of clinical data of patients with BMs undergoing surgery from December 2015 to January 2019 in Fudan University Shanghai Cancer Center (FUSCC). Analyzing the clinical characteristics, treatment and survival of brain metastases. Results: A total of 103 patients were included. None worsened after surgery and, two weeks after operation, 18 (17.5%) patients demonstrated an unchanged postoperative neurological examination while 85 patients (82.5%) showed an improvement. Three months after operation, 91 cases (88.3%) were stable, 4 cases progressed (3.9%) and 8 cases died (7.8%). The median survival time was 20 months, nearly two times longer than previously reported. 28 cases (27.2%) had a survival fewer of six months, 62 (60.2%) of 1 year, 36 (35.0%) of 2 years, 17 (16.5%) of 3 years and the longest survival time was 47 months in 1 case, and it is still under follow-up. Univariate analysis identified age over 60 (P=0.045), metastatic tumor size ≥ 3 cm (P=0.002), and high level of tumor markers (P=0.029) as positive prognostic factors. Multivariate analysis identified metastatic tumor size ≥ 3 cm (P=0.009) as an independent negative prognostic factor. Conclusion: Surgery is a safe and effective option to manage brain metastases which can alleviate clinical symptoms, prolong survival time and improve patients’ prognosis. It is not a too aggressive strategy. We suggest surgery as an important part of the comprehensive treatment of BMs, even as the preferred strategy in some cases. Metastasis tumor size ≥ 3 cm (P=0.029) was an independent negative prognostic factor for patients with brain metastases.
Feng M, Zhou C, Cui H, Gao Y, Cao Y. Surgical Treatment and Prognosis of Brain Metastases. Clin Surg. 2022; 7: 3449..