SARCOMA METASTATIC TO THE BRAIN - RESULTS OF SURGICAL-TREATMENT

WE REPORT ON 21 patients surgically treated for intraparenchymal brain metastasis from sarcoma, including six osteosarcomas, four leiomyosar comas, three malignant fibrous histiocytomas, two alveolar soft-part s arcomas, two Ewing's bone sarcomas, one extraskeletal osteosarcoma, on e extraskeletal Ewing's sarcoma, and two unclassified sarcomas. Median survival after craniotomy was 11.8 months, Patients with a preoperati ve Karnofsky performance score of > 70 survived for 15.7 versus 6.6 mo nths for those with a Karnofsky performance score less than or equal t o 70. Patients undergoing complete resection survived 14.0 versus 6.2 months for patients undergoing incomplete resection. Patients with evi dence of lung metastases at the time of surgery survived 11.8 months, which was similar to the 10.5-month survival for patients with disease limited to the brain. The two patients with alveolar soft-part sarcom a are alive at 16 and 25 months after surgery. We conclude that surger y is effective in treating selected patients with sarcoma metastatic t o the brain and that patients with metastasis from alveolar soft-part sarcoma may have a relatively good prognosis if they are surgically tr eated. The complete removal of all brain metastases and a Karnofsky pe rformance score > 70 are associated with a favorable prognosis, wherea s the presence of concurrent lung metastases is not a contraindication to surgery.