Is surgical resection of the lesion mandatory for brain metastases
Should patients with brain metastases undergo surgical resection of the lesion?
Surgery can be useful for symptomatic relief and local tumor control and provide a histiologic diagnosis in patients with single brain metastases, controlled primary cancer, and no extracranial disease.
Patients with a few small brain metastases (diameter of 3 cm or less) are treated with stereotactic radiosurgery.
Treatment with whole brain radiation following surgery or stereotactic radiosurgery is controversial as it improves local control but not overall survival.
It also increases the risk of cognitive decline following radiation. Patients with either large or multiple metastases should be treated with whole brain radiation.
