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@ARTICLE{Goldberg:305558,
      author       = {M. Goldberg and L. M. Kraus and C. Vatcheva and D.
                      Bernhardt$^*$ and S. E. Combs$^*$ and C. Negwer and B. Meyer
                      and A. Wagner},
      title        = {{E}valuating the {I}mpact of {I}ndex {M}etastasis
                      {R}esection in {P}atients with {M}ultiple {B}rain
                      {M}etastases.},
      journal      = {Cancers},
      volume       = {17},
      number       = {20},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2025-02228},
      pages        = {3281},
      year         = {2025},
      abstract     = {The impact of surgical resection on the survival and
                      functional outcomes of patients with multiple brain
                      metastases remains a critical question in
                      neuro-oncology.This retrospective study involved 160
                      patients who underwent surgical resection of brain
                      metastases from 2017 to 2020. Patients were classified by
                      the number of metastases-single, oligometastatic, or
                      multiple-and whether complete removal of the main
                      symptomatic lesion was achieved. Outcomes such as survival
                      rates, complications, and functional status were
                      assessed.Among the patients, $48.1\%$ had a single
                      metastasis, $21.9\%$ were oligometastatic, and $30\%$ had
                      multiple metastases. Survival did not differ by number of
                      metastases when the main lesion was completely resected and
                      remaining lesions were radiated (p = 0.6172). Complete
                      resection increased mean survival to 15.74 months compared
                      with 4.5 months without it. Additionally, patients who
                      underwent complete resection experienced fewer seizures
                      $(16.2\%$ vs. $32.6\%,$ p = 0.019), implying a lower seizure
                      risk. Functional independence was maintained
                      post-surgery.While multiple brain metastases are generally
                      associated with poor outcomes, a trend toward longer
                      survival was observed after complete resection of the index
                      metastasis, though this was not statistically significant.
                      Radiation of residual lesions remains important to support
                      prognosis. Reducing the tumor volume is key to lowering
                      seizure risk. This study supports the role of aggressive
                      surgical interventions, paired with radiation, to
                      potentially enhance outcomes in patients with multiple brain
                      metastases.},
      keywords     = {brain metastases (Other) / neuro-oncology (Other) /
                      neurosurgical resection (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41154339},
      doi          = {10.3390/cancers17203281},
      url          = {https://inrepo02.dkfz.de/record/305558},
}