The role of surgical resection versus stereotactic radiosurgery in the management of brain metastases

Brain metastases commonly arise in cancer patients and carry a poor prognosis. Both surgical resection and highly focused radiation techniques such as stereotactic radiosurgery (SRS) aim to improve clinical outcomes by controlling brain metastases at the local site. Determining which patient will benefit the most from surgical resection and/or SRS depends on that patient’s clinical and tumor features. This chapter will discuss the landmark studies demonstrating the efficacy of surgical resection and SRS in the management of brain metastases as well as data attempting to compare the two modalities. Important considerations for deciding when to implement surgery and/or SRS will also be covered.