Brain metastases with an unknown primary: a clinical perspective |
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Authors: | Libni Eapen Mylene Vachet Gordon Catton Cyril Danjoux Rebecca McDermot Bhavani Nair Andre Girard Paul Genest David Stewart Lee Gerig |
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Institution: | (1) Ottawa Regional Cancer Centre, Ottawa, Canada;(2) The Ontario Cancer Treatment and Research Foundation, 190 Melrose Avenue, KlY 4K7 Ottawa, Ontario, Canada |
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Abstract: | A review of 43 patients with cerebral metastases, an unknown primary, and no other sites of metastases is presented. 27/43 (62.7%) had solitary metastases and 37.2% (16/43) had multiple metastases. Surgical treatment involved complete resection in 30.2%, subtotal resection in 37.2% and biopsy alone or no surgical procedure in the remainder. 39/43 patients underwent whole brain irradiation with the majority receiving 3000–4000 rads/10–20 fractions. Overall survival was 52% at six months and 20% at one year, and was significantly better in patients with solitary as opposed to multiple metastases (p < 0.03). A failure analysis including autopsy data demonstrates that (28/41) 68.3% of patients died of progressive intracranial disease without extracerebral metastases. Implications for treatment strategies are discussed. |
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Keywords: | CNS malignancy solitary brain metastases unknown primary survival failure analysis |
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