| Abstract: | Retrospective analysis of 88 patients treated for brain metastases at Veterans Administration and Erie County Medical Centers, Buffalo, New York, between January 1975 and August 1980 is presented. Patients were followed until January 1981. They were classified into three groups: Group I—15 patients with solitary brain metastases treated by surgical excision followed by radiotherapy (SBM-S). Group II—32 patients with solitary brain metastases treated by radiotherapy alone (SBM-RT). Group III—41 patients with multiple brain metastases treated by radiotherapy (MBM-RT). The average survival was 216 days for the first group versus 80 and 106 days for the second and third groups, respectively. Three patients in the first group were still living at five, eighteen, and twenty-one months versus one patient each in the second and third group at five months. When brain metastases appeared either at time of presentation or within two months from the diagnosis of the primary disease, excision of solitary brain metastases did not prolong survival. Survival periods were 114, 53, and 81 days for Group I, II, and III, respectively. When brain metastasis appeared after a minimum of two months from the treatment of the primary lesion, excision of solitary brain metastasis did prolong patient survivals for 286 days versus 128 and 94 days for Groups I, II, and III, respectively. When the primary site of origin was inoperable lung cancer or unknown primary cancer no difference in survival between the three groups, survival was 80, 50, and 70 days for Groups I, II, and III, respectively. Percentage survival at 2, 6, and 12 months was 67%, 53%, and 27% in the first group versus 32%, 16%, and 3% for the second group and 41%, 15%, and 5% for the third group. We conclude that excision of solitary brain metastasis might prolong survival in selected patients. |
