Craniotomy for brain metastases: a consecutive series of 316 patients

Rogne SG, Rønning P, Helseth E, Johannesen TB, Langberg CW, Lote K, Scheie D, Meling TR. Craniotomy for brain metastases: a consecutive series of 316 patients.
Acta Neurol Scand: 2012: 126: 23–31.
© 2011 John Wiley & Sons A/S. Objective –  To assess the incidence of craniotomy for brain metastases, overall survival (OS), surgical mortality, and prognostic factors in a large, contemporary, consecutive series from a well‐defined catchment area. Material and methods –  All patients ≥18 years who underwent craniotomies for intracranial metastases at Oslo University Hospital, Rikshospitalet and Ullevål, between 2005 and June 30, 2009 were included ( n  = 316). Patients were identified from our prospectively collected database and a thorough review of all charts to validate the entered data was performed. Results –  The annual incidence of first‐time craniotomy for a brain metastasis was 2.6/100,000 inhabitants. Patient age ranged from 25 to 87 years (median 64 years). The 30‐day mortality rate was 3.8%. Median OS was 9.2 months. Recursive partitioning analysis was class I in 19.6%, class II in 59.2%, and class III in 21.2% with median OS of 16.2, 8.9, and 5.6 months, respectively ( P  <   0.001). Lung cancer and melanoma were associated with a higher risk (>1% per year) of developing brain metastases. Significant negative prognostic factors were age ≥65, a poor performance score, unstable extracranial disease, presence of extracranial metastases, multiplicity, metastasis in eloquent area, and no post‐operative radiotherapy. Conclusions –  In this population study, the annual incidence of a first‐time craniotomy for a brain metastasis was 2.6/100,000, the 30‐day mortality rate was 3.8%, and median OS was 9.2 months. The well‐known prognostic factors were confirmed.