title: Craniotomy for brain metastases: a consecutive series of 316 patients.
abstract: OBJECTIVE
  To assess the incidence of craniotomy for brain metastases, overall survival (OS), surgical mortality, and prognostic factors in a large, contemporary, consecutive series from a well-defined catchment area.
  
  
  METHODS
  All patients ≥ 18 years who underwent craniotomies for intracranial metastases at Oslo University Hospital, Rikshospitalet and Ullevål, between 2005 and June 30, 2009 were included (n = 316). Patients were identified from our prospectively collected database and a thorough review of all charts to validate the entered data was performed.
  
  
  RESULTS
  The annual incidence of first-time craniotomy for a brain metastasis was 2.6/100,000 inhabitants. Patient age ranged from 25 to 87 years (median 64 years). The 30-day mortality rate was 3.8%. Median OS was 9.2 months. Recursive partitioning analysis was class I in 19.6%, class II in 59.2%, and class III in 21.2% with median OS of 16.2, 8.9, and 5.6 months, respectively (P < 0.001). Lung cancer and melanoma were associated with a higher risk (>1% per year) of developing brain metastases. Significant negative prognostic factors were age ≥ 65, a poor performance score, unstable extracranial disease, presence of extracranial metastases, multiplicity, metastasis in eloquent area, and no post-operative radiotherapy.
  
  
  CONCLUSIONS
  In this population study, the annual incidence of a first-time craniotomy for a brain metastasis was 2.6/100,000, the 30-day mortality rate was 3.8%, and median OS was 9.2 months. The well-known prognostic factors were confirmed.
authors: Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: S G
authors: SG
authors: Rogne
authors: P
authors: P
authors: Rønning
authors: E
authors: E
authors: Helseth
authors: T B
authors: TB
authors: Johannesen
authors: C W
authors: CW
authors: Langberg
authors: K
authors: K
authors: Lote
authors: D
authors: D
authors: Scheie
authors: T R
authors: TR
authors: Meling
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000601:surgery*; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003399:Craniotomy / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome