Reevaluation of Surgery for the Treatment of Brain Metastases: Review of 208 Patients with Single or Multiple Brain Metastases Treated at One Institution with Modern Neurosurgical Techniques

Abstract

In most patients with single or multiple brain metastases, surgical resection reversed or stabilized neurological symptoms with therapeutic benefit, conveying a notable survival advantage without apparent increased risk, particularly in RPA Class I patients. In patients with Grade III single metastasis or RPA Class II multiple metastasis, surgical judgment should be exercised, and stereotactic radiosurgery boost treatment may be preferable. An algorithm for treatment of brain metastases is proposed.