Resection for solitary brain metastasis. Role of adjuvant radiation and prognostic variables in 229 patients.


:The authors reviewed 229 consecutive patients treated intramurally by resection of solitary cerebral metastasis. Patients were classified into four groups on the basis of whether a gross total resection or subtotal resection was performed and whether systemic disease was present or absent at the time of craniotomy. Group 1 had gross total resection and no systemic disease; Group 2 had subtotal resection and no systemic disease; Group 3 had subtotal resection and systemic disease; and Group 4 had gross total resection and systemic disease. All four groups were further subdivided into Subgroup A (adjuvant whole-brain radiation therapy) or Subgroup B (no adjuvant radiation). Data were collected regarding multiple patient and tumor variables for multivariate analysis. Survival data for the 46 patients in Group 1A (median 1.3 years, 2-year survival rate 41%, 5-year survival rate 21%) were markedly better than those for the 75 in Group 1B (median 0.7 year, 2-year survival rate 19%, 5-year survival rate 4%). The 20 patients in Group 2A also had superior survival data (median 1.1 years, 2-year survival rate 30%, 3-year survival rate 30%) when compared with the eight patients in Group 2B (median 3 months, 1-year survival rate 0%). However, the 16 and 22 patients in Groups 3A and 4A, respectively, had no discernible differences compared to the seven and 35 patients in their Group 3B and 4B counterparts. Multivariate analyses were performed to assess the association of survival with multiple patient, disease, and treatment variables. Poor neurological status and systemic disease were significantly associated with inferior survival, while longer (greater than 36 months) intervals between primary diagnosis and craniotomy were significantly associated with improved survival. After adjusting for the effects of other patient, disease, and treatment characteristics, adjuvant whole-brain radiotherapy was significantly associated with improved survival times. These data support the continued use of craniotomy followed by adjuvant whole-brain radiation therapy for treatment of solitary brain metastasis. However, this aggressive therapy appears relatively contraindicated in the face of either systemic disease or substantial neurological deficit.


J Neurosurg


Journal of neurosurgery


Smalley SR,Laws ER Jr,O'Fallon JR,Shaw EG,Schray MF




Has Abstract


1992-10-01 00:00:00












  • Carcinoembryonic antigen in patients with intracranial tumors.

    abstract::Carcinoembryonic antigen (CEA) in plasma, cerebrospinal fluid (CSF), and tumor cyst fluid obtained from patients with a variety of intracranial tumors was determined by radioimmunoassay Slightly elevated levels of plasma CEA, ranging from 2.6 to 3.8 ng/ml, were noted in six (4%) of 161 patients with primary brain tumo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Suzuki Y,Tanaka R

    更新日期:1980-09-01 00:00:00

  • Direct visualization of microcirculation impairment after acute subdural hemorrhage in a novel animal model.

    abstract:OBJECTIVE:Direct brain compression and secondary injury due to increased intracranial pressure are believed to be the pathognomic causes of a grave outcome in acute subdural hemorrhage (aSDH). However, ischemic damage from aSDH has received limited attention. The authors hypothesized that cerebral microcirculation is a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wang HC,Tsai JC,Lee JE,Huang SJ,Po-Hao Huang A,Lin WC,Hsieh ST,Wang KC

    更新日期:2018-10-01 00:00:00

  • Dorsal component of the superior longitudinal fasciculus revisited: novel insights from a focused fiber dissection study.

    abstract:OBJECTIVE:The aim of this study was to investigate the anatomical consistency, morphology, axonal connectivity, and correlative topography of the dorsal component of the superior longitudinal fasciculus (SLF-I) since the current literature is limited and ambiguous. METHODS:Fifteen normal, adult, formalin-fixed cerebra...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Komaitis S,Skandalakis GP,Kalyvas AV,Drosos E,Lani E,Emelifeonwu J,Liakos F,Piagkou M,Kalamatianos T,Stranjalis G,Koutsarnakis C

    更新日期:2019-03-01 00:00:00

  • Risk factors and analysis of long-term headache in sporadic vestibular schwannoma: a multicenter cross-sectional study.

    abstract:OBJECT:The primary goals of this study were: 1) to examine the influence of disease and treatment on headache in patients with sporadic vestibular schwannoma (VS); and 2) to identify clinical predictors of long-term headache disability. METHODS:This was a cross-sectional observational study with international multicen...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,多中心研究


    authors: Carlson ML,Tveiten ØV,Driscoll CL,Boes CJ,Sullan MJ,Goplen FK,Lund-Johansen M,Link MJ

    更新日期:2015-11-01 00:00:00

  • Frontoorbital advancement by gradual distraction. Technical note.

    abstract::A substantial number of patients with coronal synostosis who undergo frontoorbital advancement still require additional surgical treatment to correct increased intracranial pressure or unsatisfactory craniofacial structure. However, frontoorbital advancement currently requires elevation of the frontal as well as the o...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Hirabayashi S,Sugawara Y,Sakurai A,Harii K,Park S

    更新日期:1998-12-01 00:00:00

  • A randomized comparison of intra-arterial versus intravenous BCNU, with or without intravenous 5-fluorouracil, for newly diagnosed patients with malignant glioma.

    abstract::This Phase III trial tested the efficacy and safety of intra-arterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) for the treatment of newly resected malignant glioma, comparing intra-arterial BCNU and intravenous BCNU (200 mg/sq m every 8 weeks), each regimen without or with intravenous 5-fluorouracil (1 gm/sq m thre...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Shapiro WR,Green SB,Burger PC,Selker RG,VanGilder JC,Robertson JT,Mealey J Jr,Ransohff J,Mahaley MS Jr

    更新日期:1992-05-01 00:00:00

  • Characterizing the heterogeneity in 5-aminolevulinic acid-induced fluorescence in glioblastoma.

    abstract:OBJECTIVE:5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence is an effective surgical adjunct for the intraoperative identification of tumor tissue during resection of high-grade gliomas. The use of 5-ALA-induced PpIX fluorescence in glioblastoma (GBM) has been shown to double the extent of gro...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Almiron Bonnin DA,Havrda MC,Lee MC,Evans L,Ran C,Qian DC,Harrington LX,Valdes PA,Cheng C,Amos CI,Harris BT,Paulsen KD,Roberts DW,Israel MA

    更新日期:2019-05-24 00:00:00

  • Striatal hyperintensity on T1-weighted magnetic resonance images and high-density signal on CT scans obtained in patients with hyperglycemia and no involuntary movement. Report of two cases.

    abstract::The authors report on two patients in whom an increased signal on T1-weighted magnetic resonance images and a high-density signal on computerized tomography scans of the striatum were demonstrated, both of which were associated with nonketotic hyperglycemia. Involuntary movements, which have been present in all previo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Sorimachi T,Fujii Y,Tsuchiya N,Saito M

    更新日期:2004-08-01 00:00:00

  • Hemangiopericytoma of the spinal canal. Report of three cases.

    abstract::Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Harris DJ,Fornasier VL,Livingston KE

    更新日期:1978-12-01 00:00:00

  • Effects of blood coagulation factor XIII on the development of experimental cerebral aneurysms in rats.

    abstract::Pathological and experimental studies have shown that cerebral aneurysms develop in part as a result of injury to the blood vessel wall. One of the peculiar aspects of aneurysm development is a defective proliferative or healing response to such injury. To examine this phenomenon, blood coagulation Factor XIII, which ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Kang Y,Hashimoto N,Kikuchi H,Yamazoe N,Hazama F

    更新日期:1990-08-01 00:00:00

  • Does adjuvant external-beam radiotherapy improve outcomes for nonbenign meningiomas? A Surveillance, Epidemiology, and End Results (SEER)-based analysis.

    abstract:OBJECT:The aim of this study was to examine the effect of postoperative external-beam radiation therapy (EBRT) on disease-specific survival in patients with nonbenign meningiomas. METHODS:The Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2007 was queried for cases of resected Grades II (atyp...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Stessin AM,Schwartz A,Judanin G,Pannullo SC,Boockvar JA,Schwartz TH,Stieg PE,Wernicke AG

    更新日期:2012-10-01 00:00:00

  • Association between a black band on the inner membrane of a chronic subdural hematoma on T2*-weighted magnetic resonance images and enlargement of the hematoma.

    abstract:OBJECT:The cause and indication for enlargement of chronic subdural hematomas (CSDHs) have remained unresolved. The authors observed a black band on the inner membrane of a CSDH on T2*-weighted magnetic resonance (MR) images obtained in patients with symptoms. After surgical treatment, the band disappeared. The T2*-wei...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Imaizumi T,Horita Y,Honma T,Niwa J

    更新日期:2003-11-01 00:00:00

  • The role of NLRP3 in traumatic brain injury and its regulation by pioglitazone.

    abstract:OBJECTIVE:Perilesional edema is a predominant mechanism underlying secondary brain injury after traumatic brain injury (TBI). Perilesional edema is characterized by inflammation, production of proinflammatory cytokines, and migration of peripheral immune cells into the brain. The nucleotide-binding domain and leucine-r...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Yi HJ,Lee JE,Lee DH,Kim YI,Cho CB,Kim IS,Sung JH,Yang SH

    更新日期:2019-09-27 00:00:00

  • Cortical stimulation mapping of language cortex by using a verb generation task: effects of learning and comparison to mapping based on object naming.

    abstract:OBJECT:Cortical stimulation mapping has traditionally relied on disruption of object naming to define essential language areas. In this study, the authors reviewed the use of a different language task, verb generation, in mapping language. This task has greater use in brain imaging studies and may be used to test aspec...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ojemann JG,Ojemann GA,Lettich E

    更新日期:2002-07-01 00:00:00

  • A new technique for exposure of the cervical spine laminae. Technical note.

    abstract::The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. I...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Shiraishi T

    更新日期:2002-01-01 00:00:00

  • Hyperprolactinemia, intrasellar pituitary tissue pressure, and the pituitary stalk compression syndrome.

    abstract::The intrasellar pressure has been studied in a consecutive series of 24 patients undergoing transsphenoidal surgery for pituitary adenoma. The mean intrasellar pressure for the group was 23 +/- 2.5 mm Hg (+/- standard error of the mean), with a mean pulse pressure of 3.5 +/- 1 mm Hg. The waveform partly resembled the ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Lees PD,Pickard JD

    更新日期:1987-08-01 00:00:00

  • Bifrontal decompressive craniectomy in the management of head trauma.

    abstract::Retrospective analysis of 13 patients who had bifrontal decompressive craniectomy for the management of posttraumatic cerebral edema shows a significant decrease in expected mortality, but severe morbidity in the survivors. Only one patient returned to the pretrauma level of neurological function. No correlation could...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Venes JL,Collins WF

    更新日期:1975-04-01 00:00:00

  • Correlation of personality assessments with standard selection criteria for neurosurgical residency applicants.

    abstract::OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Ex...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Lubelski D,Healy AT,Friedman A,Ferraris D,Benzel EC,Schlenk R

    更新日期:2016-10-01 00:00:00

  • Contralateral vertebral approach for stenting and coil embolization of a large, thrombosed vertebral-posterior inferior cerebellar artery aneurysm. Case report.

    abstract::The authors report the successful staged stenting and coil embolization of a large vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm using the contralateral VA for access. A 67-year-old woman presented with a large ruptured VA-PICA aneurysm. Initial attempts to stent the wide-necked aneurysm fro...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ecker RD,Hanel RA,Levy EI,Hopkins LN

    更新日期:2007-12-01 00:00:00

  • Reoperation and readmission after clipping of an unruptured intracranial aneurysm: a National Surgical Quality Improvement Program analysis.

    abstract::OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Dasenbrock HH,Smith TR,Rudy RF,Gormley WB,Aziz-Sultan MA,Du R

    更新日期:2018-03-01 00:00:00

  • Microsurgical anatomy of the central core of the brain.

    abstract::OBJECTIVE The purpose of this study was to describe in detail the cortical and subcortical anatomy of the central core of the brain, defining its limits, with particular attention to the topography and relationships of the thalamus, basal ganglia, and related white matter pathways and vessels. METHODS The authors stud...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ribas EC,Yağmurlu K,de Oliveira E,Ribas GC,Rhoton A

    更新日期:2018-09-01 00:00:00

  • Imaging features in combined atlantoaxial and occipitoatlantal rotatory subluxation: a rare entity. Case report.

    abstract::The authors report a new case of combined atlantoaxial and occipitoatlantal rotatory subluxation in a 17-year-old girl. They describe the clinical and imaging features of this rare entity. An occiput-C2 arthrodesis was performed. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Bouillot P,Fuentes S,Dufour H,Manera L,Grisoli F

    更新日期:1999-04-01 00:00:00

  • Early results of CyberKnife radiosurgery for arteriovenous malformations.

    abstract:OBJECT:The authors describe a method that utilizes an image-guided robotic radiosurgical apparatus (the CyberKnife) for treatment of cerebral arteriovenous malformations (AVMs). This procedure required the development of an original technique that allows a high degree of automation. METHODS:Angiographic images were im...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Colombo F,Cavedon C,Casentini L,Francescon P,Causin F,Pinna V

    更新日期:2009-10-01 00:00:00

  • Assessing variability in surgical decision making among attending neurosurgeons at an academic center.

    abstract:OBJECTIVE:Although it is known that intersurgeon variability in offering elective surgery can have major consequences for patient morbidity and healthcare spending, data addressing variability within neurosurgery are scarce. The authors performed a prospective peer review study of randomly selected neurosurgery cases i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ramayya AG,Chen HI,Marcotte PJ,Brem S,Zager EL,Osiemo B,Piazza M,Sharma N,McClintock SD,Schuster JM,Ali ZS,Connolly P,Heuer GG,Grady MS,Kung DK,Ozturk AK,O'Rourke DM,Malhotra NR

    更新日期:2019-05-31 00:00:00

  • Medical treatment decision making after total avulsion brachial plexus injury: a qualitative study.

    abstract:OBJECT:Complete avulsion traumatic brachial plexus injuries (BPIs) can be treated using nerve and musculoskeletal reconstruction procedures. However, these interventions are most viable within certain timeframes, and even then they cannot restore all lost function. Little is known about how patients make decisions rega...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Franzblau LE,Maynard M,Chung KC,Yang LJ

    更新日期:2015-06-01 00:00:00

  • The clinical significance and optimal timing of postoperative computed tomography following cranial surgery.

    abstract:OBJECT:This study was conducted to evaluate the value of postoperative CT scans in determining the probability of return to the operating room (OR) and the optimal time to obtain such scans to determine the effects of surgery. METHODS:Between January and December 2006 (12 months), all postoperative head CT scans obtai...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Khaldi A,Prabhu VC,Anderson DE,Origitano TC

    更新日期:2010-11-01 00:00:00

  • Pathophysiology and treatment of focal cerebral ischemia. Part II: Mechanisms of damage and treatment.

    abstract::The mechanisms that give rise to ischemic brain damage have not been definitively determined, but considerable evidence exists that three major factors are involved: increases in the intercellular cytosolic calcium concentration (Ca++i), acidosis, and production of free radicals. A nonphysiological rise in Ca++i due t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审


    authors: Siesjö BK

    更新日期:1992-09-01 00:00:00

  • Intraparenchymal embolization for obliteration of an intramedullary AVM of the spinal cord. Technical note.

    abstract::A new technique is presented in which expandable compressed Ivalon sponge emboli were used to obliterate an intramedullary arteriovenous malformation of the spinal cord by intraparenchymal embolization. A case is described in which this method was used. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ausman JI,Gold LH,Tadavarthy SM,Amplatz K,Chou SN

    更新日期:1977-07-01 00:00:00

  • Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features.

    abstract::OBJECTIVE Treatment with a BRAF mutation inhibitor might shrink otherwise refractory craniopharyngiomas and is a promising preoperative treatment to facilitate tumor resection. The aim of this study was to investigate the noninvasive diagnosis of BRAF-mutated craniopharyngiomas based on MRI characteristics. METHODS Fi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Yue Q,Yu Y,Shi Z,Wang Y,Zhu W,Du Z,Yao Z,Chen L,Mao Y

    更新日期:2018-07-01 00:00:00

  • Production of experimental brain abscess in the rat.

    abstract::Experimental evaluation of brain abscess has been inhibited by the lack of a simple and reproducible model in small animals. A stereotaxic headholder and slow infusion of 1 microliter of saline, containing a known number of bacteria, were used to produce brain abscess consistently in the rat. The natural history of th...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Winn HR,Mendes M,Moore P,Wheeler C,Rodeheaver G

    更新日期:1979-11-01 00:00:00