Outcome after craniotomy for recurrent cranial metastases.

OBJECTIVE: To investigate the outcomes of patients with recurrent/progressive cranial metastases who underwent re-do craniotomy and to assess the utility of surgery as a treatment option.

METHODS: A retrospective study was conducted assessing survival after re-do craniotomy for recurrent or progressive cranial metastases. 29 patients were identified between January 2006 and December 2013. Data was gathered from a prospective pathology database, patients' notes and electronic records. The diagnosis of cranial metastasis was obtained through pathological analysis at the time of tumour resection. Results were analysed with Cox regression tests and converted into a Kaplan-Meier curve.

RESULTS: Median patient age was 57 years old (range 24-74 years) at diagnosis of brain metastases. Two patients had serious complications after re-do surgery. Five patients had >2 craniotomies for recurrent disease. Median survival after the first craniotomy was 18 months (range 4.1-50.9 months). Median survival after re-do craniotomy was 7.6 months (range 0.2-31.3 months). 90% of patients survived at least 3 months after re-do surgery, 65.5% survived at least 6 months.

CONCLUSION: This study suggests that re-do surgery is a viable treatment option for patients with recurrent cranial metastases.