Development of a scoring system to predict local recurrence after complete resection of brain metastases without immediate radiotherapy

Guidelines recommend postoperative stereotactic radiosurgery to the resection cavity after complete resection of brain metastases. However, the Japanese Clinical Oncology Group 0504 study showed that postoperative observation could be an option in this setting. A retrospective study at the National Cancer Center Hospital (Tokyo) investigated incidence of and risk factors for local recurrence after complete resection without immediate radiotherapy. The study included 53 patients with 54 brain metastases. During median 21.0 months of follow-up, local recurrence occurred in 37 of 54 tumor (68.5%), with median time to local recurrence 5.1 months. Risk factors for local recurrence were non-lung adenocarcinoma (p=0.0035), infratentorial tumors (p=0.044), and no postoperative systemic therapy (p=0.0069). Patients with two or three of these risk factors had a median time to local recurrence of 2.1 months, while patients with none or one of these risk factors had a median time to local recurrence of 30.8 months (p=0.0002). The authors conclude that this scoring system can predict local recurrence, potentially aiding treatment decisions.