title: Brain metastases with an unknown primary: a clinical perspective.
abstract: A review of 43 patients with cerebral metastases, an unknown primary, and no other sites of metastases is presented. 27/43 (62.7%) had solitary metastases and 37.2% (16/43) had multiple metastases. Surgical treatment involved complete resection in 30.2%, subtotal resection in 37.2% and biopsy alone or no surgical procedure in the remainder. 39/43 patients underwent whole brain irradiation with the majority receiving 3,000-4,000 rads/10-20 fractions. Overall survival was 52% at six months and 20% at one year, and was significantly better in patients with solitary as opposed to multiple metastases (p less than 0.03). A failure analysis including autopsy data demonstrates that (28/41) 68.3% of patients died of progressive intracranial disease without extracerebral metastases. Implications for treatment strategies are discussed.
authors.affiliation: Ottawa Regional Cancer Centre.
authors.forename: L
authors.initials: L
authors.lastname: Eapen
authors.forename: M
authors.initials: M
authors.lastname: Vachet
authors.forename: G
authors.initials: G
authors.lastname: Catton
authors.forename: C
authors.initials: C
authors.lastname: Danjoux
authors.forename: R
authors.initials: R
authors.lastname: McDermot
authors.forename: B
authors.initials: B
authors.lastname: Nair
authors.forename: A
authors.initials: A
authors.lastname: Girard
authors.forename: P
authors.initials: P
authors.lastname: Genest
authors.forename: D
authors.initials: D
authors.lastname: Stewart
authors.forename: L
authors.initials: L
authors.lastname: Gerig
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary