RESECTION OF BRAIN METASTASES FROM SARCOMA

Background: Brain metastases from sarcoma are rare, and data concernin g the treatment and results of therapy are sparse. Methods: We retrosp ectively reviewed 25 patients with brain metastases from sarcoma of sk eletal or soft-tissue origin, surgically treated in a single instituti on during 20 years. Results: In 18 patients the brain lesion was locat ed supratentorially, and in 7 patients infratentorially. Median age at brain metastasis diagnosis was 25 years, Median time from primary dia gnosis to diagnosis of brain metastasis was 26.7 months. Lung metastas es were present in 19 patients and in 8 patients they were synchronous with the brain lesion. Pulmonary metastases were resected in 12 patie nts (48% of total, and 63% of these with pulmonary lesions). The overa ll median survival from diagnosis of the primary sarcoma was 38 months and from craniotomy was 7 months. The presence or absence of lung les ions did not alter the median survival as calculated from diagnosis of brain metastasis. Overall percent survival was 40% at 1 year and 16% at 2 years. Conclusions: Because brain metastases from sarcoma are ref ractory to alternative treatment, surgical excision is indicated when feasible. Brain metastases from sarcoma are uncommon, usually occurrin g with or after lung metastasis. Long-term survival is possible in som e patients.