The threefold value of surgery in previously irradiated brain metastases.
Surgery patients with radiation necrosis lived longer than those with tumor recurrence.
The threefold value of surgery in previously irradiated brain metastases.
Differentiating radiation necrosis (radiation necrosis) from tumor recurrence (tumor recurrence) in previously irradiated brain metastases (brain metastases) remains a challenge.
This study aims to evaluate the diagnostic, therapeutic, and prognostic value of surgery in patients with progressive irradiated brain metastases.
We studied patients who underwent surgical resection for progressive brain metastases after prior irradiation.
surgery for radiation necrosis gave much longer survival than surgery for recurrence
In 73 lesions, histopathology demonstrated tumor recurrence in 68.5% of lesions.
Among tumor recurrence, 84.0% showed mixed pathological features combining viable tumor cells and radionecrotic patterns.
Median interval between radiation and surgery was significantly longer in the radiation necrosis group and breast cancer seemed related to radiation necrosis.
Surgery provides diagnostic, therapeutic, and prognostic value in patients with progressive irradiated brain metastases.
Beyond diagnostic clarification, surgery provides significant symptomatic improvement and corticosteroid withdrawal regardless of final pathology.
Histopathological diagnosis influences survival outcomes and subsequent oncological management.