PMID- 8738387
OWN - NLM
STAT- MEDLINE
DCOM- 19961105
LR  - 20190814
IS  - 0001-6268 (Print)
IS  - 0001-6268 (Linking)
VI  - 138
IP  - 4
DP  - 1996
TI  - Surgical resection of brain metastases from lung cancer.
PG  - 382-9
AB  - The role of surgical resection for brain metastases is evolving. The most common 
      primary for brain metastases is lung; in the US in 1992, for example, there were 
      nearly 40,000 deaths with symptomatic brain metastases from lung cancer. We 
      reviewed a series of 25 consecutive patients with non small cell lung cancer 
      (NSCLC) undergoing open resection of one or more symptomatic brain metastases to 
      consider the role of open resection. Twenty-three of the 28 resected lesions were 
      3 cm or greater in diameter; 19 were solid and nine cystic. Surgical adjuncts 
      included (where indicated): stereotactic biopsy, cyst drainage, and craniotomy; 
      intra-operative ultrasound; and intra-operative evoked potential mapping of the 
      sensorimotor area. Six patients underwent thoracotomy for resection of the lung 
      primary (in all but one case, prior to craniotomy). Except for two patients who 
      had whole brain radiation therapy (WBXRT) prior to referral to Neurosurgery, all 
      patients underwent WBXRT (30 to 60 Gy) postoperatively. The mean survival from 
      date of craniotomy was 13.1 months, with two patients still alive at ten and 
      seventeen months post-craniotomy. Survival comparisons which were significantly 
      different included (1) lung surgery versus no lung surgery (25.7 months versus 
      9.1 months, P < 0.001), and (2) metachronous presentation of the lung primary and 
      brain metastasis versus synchronous presentation (17.6 months versus 9.5 months, 
      P = 0.025). Survival comparisons which were not significantly different included 
      single versus multiple metastases, complete versus incomplete resection, 
      adenocarcinoma versus large or squamous or cell histology, supratentorial versus 
      infratentorial location, solid versus cystic metastasis, and age < or = 60 years 
      versus > 60 years. These results, when compared with the literature on brain 
      metastases, suggest that aggressive resection of symptomatic metastases from lung 
      cancer (even if multiple) can improve functional survival over conservative 
      management, and that small, asymptomatic lesions are well-controlled by WBXRT. 
      They also confirm the previous finding that surgical treatment of both the lung 
      primary and the brain metastases may afford the greatest period of functional 
      survival for these patients.
FAU - Andrews, R J
AU  - Andrews RJ
AD  - Department of Neurosurgery, Stanford University Medical Center, CA, USA.
FAU - Gluck, D S
AU  - Gluck DS
FAU - Konchingeri, R H
AU  - Konchingeri RH
LA  - eng
PT  - Journal Article
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Adult
MH  - Aged
MH  - Brain Neoplasms/pathology/radiotherapy/*secondary/surgery
MH  - Carcinoma, Non-Small-Cell Lung/pathology/radiotherapy/*secondary/surgery
MH  - Combined Modality Therapy
MH  - Cranial Irradiation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/mortality/pathology/radiotherapy/*surgery
MH  - Male
MH  - Middle Aged
MH  - Radiotherapy, Adjuvant
MH  - Survival Rate
MH  - Tomography, X-Ray Computed
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - 10.1007/BF01420299 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 1996;138(4):382-9. doi: 10.1007/BF01420299.