Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis

Uma V. Mahajan; Ansh Desai; Michael D. Shost; Yang Cai; Austin Anthony; Collin M. Labak; Eric Z. Herring; Olindi Wijesekera; Debraj Mukherjee; Andrew E. Sloan; Tiffany R. Hodges

doi:10.3171/2022.8.FOCUS22369

Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis

Uma V. Mahajan
, Ansh Desai
, Michael D. Shost
, Yang Cai
, Austin Anthony
, Collin M. Labak
, Eric Z. Herring
, Olindi Wijesekera
, Debraj Mukherjee
, Andrew E. Sloan
, Tiffany R. Hodges

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE Stereotactic radiosurgery (SRS) has recently emerged as a minimally invasive alternative to resection for treating multiple brain metastases. Given the lack of consensus regarding the application of SRS versus resection for multiple brain metastases, the authors aimed to conduct a systematic literature review of all published work on the topic. METHODS The PubMed, OVID, Cochrane, Web of Science, and Scopus databases were used to identify studies that examined clinical outcomes after resection or SRS was performed in patients with multiple brain metastases. Radiological studies, case series with fewer than 3 patients, pediatric studies, or national database studies were excluded. Data extracted included patient demographics and mean overall survival (OS). Weighted t-tests and ANOVA were performed. RESULTS A total of 1300 abstracts were screened, 450 articles underwent full-text review, and 129 studies met inclusion criteria, encompassing 20,177 patients (18,852 treated with SRS and 1325 who underwent resection). The OS for the SRS group was 10.2 ± 6 months, and for the resection group it was 6.5 ± 3.8 months. A weighted ANOVA test comparing OS with covariates of age, sex, and publication year revealed that the treatment group (p = 0.045), age (p = 0.034), and publication year (0.0078) were all independently associated with OS (with SRS, younger age, and later publication year being associated with longer survival), whereas sex (p = 0.95) was not. CONCLUSIONS For patients with multiple brain metastases, SRS and resection are effective treatments to prolong OS, with published data suggesting that SRS may have a trend toward lengthened survival outcomes. The authors encourage additional work examining outcomes of treatments for multiple brain metastases. https://thejns.org/doi/abs/10.3171/2022.8.FOCUS22369

Original language	English (US)
Article number	E9
Journal	Neurosurgical focus
Volume	53
Issue number	5
DOIs	https://doi.org/10.3171/2022.8.FOCUS22369
State	Published - 2022

Keywords

Multiple cerebral metastases
Neurosurgery
Resection
Stereotactic radiosurgery

ASJC Scopus subject areas

Surgery
Clinical Neurology

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Mahajan, U. V., Desai, A., Shost, M. D., Cai, Y., Anthony, A., Labak, C. M., Herring, E. Z., Wijesekera, O., Mukherjee, D., Sloan, A. E., & Hodges, T. R. (2022). Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis. Neurosurgical focus, 53(5), Article E9. https://doi.org/10.3171/2022.8.FOCUS22369

Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis. / Mahajan, Uma V.; Desai, Ansh; Shost, Michael D. et al.
In: Neurosurgical focus, Vol. 53, No. 5, E9, 2022.

Research output: Contribution to journal › Article › peer-review

Mahajan, UV, Desai, A, Shost, MD, Cai, Y, Anthony, A, Labak, CM, Herring, EZ, Wijesekera, O, Mukherjee, D, Sloan, AE & Hodges, TR 2022, 'Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis', Neurosurgical focus, vol. 53, no. 5, E9. https://doi.org/10.3171/2022.8.FOCUS22369

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abstract = "OBJECTIVE Stereotactic radiosurgery (SRS) has recently emerged as a minimally invasive alternative to resection for treating multiple brain metastases. Given the lack of consensus regarding the application of SRS versus resection for multiple brain metastases, the authors aimed to conduct a systematic literature review of all published work on the topic. METHODS The PubMed, OVID, Cochrane, Web of Science, and Scopus databases were used to identify studies that examined clinical outcomes after resection or SRS was performed in patients with multiple brain metastases. Radiological studies, case series with fewer than 3 patients, pediatric studies, or national database studies were excluded. Data extracted included patient demographics and mean overall survival (OS). Weighted t-tests and ANOVA were performed. RESULTS A total of 1300 abstracts were screened, 450 articles underwent full-text review, and 129 studies met inclusion criteria, encompassing 20,177 patients (18,852 treated with SRS and 1325 who underwent resection). The OS for the SRS group was 10.2 ± 6 months, and for the resection group it was 6.5 ± 3.8 months. A weighted ANOVA test comparing OS with covariates of age, sex, and publication year revealed that the treatment group (p = 0.045), age (p = 0.034), and publication year (0.0078) were all independently associated with OS (with SRS, younger age, and later publication year being associated with longer survival), whereas sex (p = 0.95) was not. CONCLUSIONS For patients with multiple brain metastases, SRS and resection are effective treatments to prolong OS, with published data suggesting that SRS may have a trend toward lengthened survival outcomes. The authors encourage additional work examining outcomes of treatments for multiple brain metastases. https://thejns.org/doi/abs/10.3171/2022.8.FOCUS22369",

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author = "Mahajan, \{Uma V.\} and Ansh Desai and Shost, \{Michael D.\} and Yang Cai and Austin Anthony and Labak, \{Collin M.\} and Herring, \{Eric Z.\} and Olindi Wijesekera and Debraj Mukherjee and Sloan, \{Andrew E.\} and Hodges, \{Tiffany R.\}",

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doi = "10.3171/2022.8.FOCUS22369",

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T2 - a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis

AU - Mahajan, Uma V.

AU - Desai, Ansh

AU - Shost, Michael D.

AU - Cai, Yang

AU - Anthony, Austin

AU - Labak, Collin M.

AU - Herring, Eric Z.

AU - Wijesekera, Olindi

AU - Mukherjee, Debraj

AU - Sloan, Andrew E.

AU - Hodges, Tiffany R.

PY - 2022

Y1 - 2022

N2 - OBJECTIVE Stereotactic radiosurgery (SRS) has recently emerged as a minimally invasive alternative to resection for treating multiple brain metastases. Given the lack of consensus regarding the application of SRS versus resection for multiple brain metastases, the authors aimed to conduct a systematic literature review of all published work on the topic. METHODS The PubMed, OVID, Cochrane, Web of Science, and Scopus databases were used to identify studies that examined clinical outcomes after resection or SRS was performed in patients with multiple brain metastases. Radiological studies, case series with fewer than 3 patients, pediatric studies, or national database studies were excluded. Data extracted included patient demographics and mean overall survival (OS). Weighted t-tests and ANOVA were performed. RESULTS A total of 1300 abstracts were screened, 450 articles underwent full-text review, and 129 studies met inclusion criteria, encompassing 20,177 patients (18,852 treated with SRS and 1325 who underwent resection). The OS for the SRS group was 10.2 ± 6 months, and for the resection group it was 6.5 ± 3.8 months. A weighted ANOVA test comparing OS with covariates of age, sex, and publication year revealed that the treatment group (p = 0.045), age (p = 0.034), and publication year (0.0078) were all independently associated with OS (with SRS, younger age, and later publication year being associated with longer survival), whereas sex (p = 0.95) was not. CONCLUSIONS For patients with multiple brain metastases, SRS and resection are effective treatments to prolong OS, with published data suggesting that SRS may have a trend toward lengthened survival outcomes. The authors encourage additional work examining outcomes of treatments for multiple brain metastases. https://thejns.org/doi/abs/10.3171/2022.8.FOCUS22369

AB - OBJECTIVE Stereotactic radiosurgery (SRS) has recently emerged as a minimally invasive alternative to resection for treating multiple brain metastases. Given the lack of consensus regarding the application of SRS versus resection for multiple brain metastases, the authors aimed to conduct a systematic literature review of all published work on the topic. METHODS The PubMed, OVID, Cochrane, Web of Science, and Scopus databases were used to identify studies that examined clinical outcomes after resection or SRS was performed in patients with multiple brain metastases. Radiological studies, case series with fewer than 3 patients, pediatric studies, or national database studies were excluded. Data extracted included patient demographics and mean overall survival (OS). Weighted t-tests and ANOVA were performed. RESULTS A total of 1300 abstracts were screened, 450 articles underwent full-text review, and 129 studies met inclusion criteria, encompassing 20,177 patients (18,852 treated with SRS and 1325 who underwent resection). The OS for the SRS group was 10.2 ± 6 months, and for the resection group it was 6.5 ± 3.8 months. A weighted ANOVA test comparing OS with covariates of age, sex, and publication year revealed that the treatment group (p = 0.045), age (p = 0.034), and publication year (0.0078) were all independently associated with OS (with SRS, younger age, and later publication year being associated with longer survival), whereas sex (p = 0.95) was not. CONCLUSIONS For patients with multiple brain metastases, SRS and resection are effective treatments to prolong OS, with published data suggesting that SRS may have a trend toward lengthened survival outcomes. The authors encourage additional work examining outcomes of treatments for multiple brain metastases. https://thejns.org/doi/abs/10.3171/2022.8.FOCUS22369

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Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysistereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis

Abstract

Keywords

ASJC Scopus subject areas

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