Brain metastases: Histology, multiplicity, surgery, and survival

Abstract

Dissemination of systemic carcinoma to the brain continues to carry a poor prognosis. Knowledge of the metastatic patterns and limited survival associated with specific tumor types may be useful for guiding future therapeutic intervention.

Brain metastasis from prostate carcinoma

“…7,8 Furthermore, the median survival of 1 month in untreated patients was reported previously for patients with brain metastases from other primary tumors. 8 This survival pattern also fits into the expected survival for patients who are categorized into recursive partitioning analysis Classes I and II. 20 Although surgery currently has a role in the palliative treatment of patients with brain metastasis, 21 very few patients in this series underwent surgical resection, preventing any meaningful analysis in this regard.…”

“…The median survival in this series of untreated patients and treated patients was similar to the survival reported in other large series in which the median survival was between 3 months and 4 months. 7,8 Furthermore, the median survival of 1 month in untreated patients was reported previously for patients with brain metastases from other primary tumors. 8 This survival pattern also fits into the expected survival for patients who are categorized into recursive partitioning analysis Classes I and II.…”

“…Conversely, more recent studies have found that a single brain metastasis from prostate carcinoma is the rule rather than the exception. 8 The inclusion of patients diagnosed from 1944 to 1979 with brain metastases from prostate carcinoma was relevant, because it made comparisons of frequency and diagnosis over time possible and provided insights into the effect of changes in diagnostic and therapeutic modalities over time on survival. We recognize that the results of such retrospective analyses of data over a long period inevitably are influenced by selection bias.…”

Antidepressant use and risk of central nervous system metastasis

“…The majority (70%) of multiple lesions occur in the cerebrum, whereas only about 4% occur exclusively in the cerebellum or brain stem, and the rest (25%) occur in both [157].…”

“…Metastatic CNS tumors should be in the differential diagnosis if a cancer patient reports neurological symptoms such as headaches, nausea, cognitive problems, seizures, dysphasia, motor weakness, or sensory disturbances, since these metastases are usually symptomatic [139,145,153,[156][157][158]. CNS metastasis symptoms can either be generalized or focal.…”