supportive articles - surgery for the brain mets/asps

[Olga]

I decided to collect some articles that might be used by the people being denied surgery to remove their brain mets (it does not mean that I advocate surgery versus radiosurgery or ablation, but in some cases conventional surgery offers the best chance for the patient).
1.
Sarcoma metastatic to the brain: a series of 15 cases.
http://www.ncbi.nlm.nih.gov/pubmed/9537665
We conclude that surgery is effective in treating selected patients with sarcoma metastatic to the brain and that patients with metastasis from ASPS may have a relatively good prognosis if they are surgically treated. The complete removal of all brain metastases and a Karnofsky performance score > 70 are associated with a favorable prognosis; the presence of concurrent lung metastases is not a contraindication to surgery.
2.
Successful treatment for solitary brain metastasis from alveolar soft part sarcoma.
http://www.ncbi.nlm.nih.gov/pubmed/8543972
Our report suggests that surgical resection for solitary brain metastasis from alveolar soft part sarcoma is an effective treatment modality.
3.
Sarcoma metastatic to the brain: a series of 35 cases and considerations from 27 years of experience.
http://www.ncbi.nlm.nih.gov/pubmed/20039192
The authors conclude that surgery is more effective in treating selected patients with sarcoma metastatic to the brain, and that patients with metastasis from ASPS have good prognosis when submitted to surgical treatment. The complete removal of all brain metastases "en bloc" and a KPS > 60 are associated with the best prognosis. Finally, it seems that surgical indications for multiple brain metastases from sarcoma have increased during the last ten years.
4.
A case of alveolar soft-part sarcoma with lung and cerebral metastasis
http://www.ncbi.nlm.nih.gov/pubmed/7242844
Regarding the choice of the treatment of this tumor, total removal was seemed to be the best management. Therefore, all efforts should be focused to discover in the earlier stage of this tumor.
5.
Brain, the last fortress of sarcoma: similar dismal outcome but discrepancy of timing of brain metastasis in bone and soft tissue sarcoma.
http://www.ncbi.nlm.nih.gov/pubmed/21714120
Univariate factors associated with better post-brain metastasis survival included ASPS histology, initial surgical treatment, and brain irradiation for non-surgically treated patients.

[D.ap]

Journal of Neurosurgery
January 2009 / Vol. 110 / No. 1 / Pages 181-186

Oncology
Surgical management of metastatic sarcoma to the brain


Conclusions
The authors' results suggest that in selected patients, resection of metastatic sarcoma to the brain is associated with a relatively low risk of operative death and results in improvement in neurological function. Patients with systemic control of their primary disease and certain histological subtypes (specifically alveolar soft-part sarcoma) have improved overall and progression-free survival.

http://thejns.org/doi/abs/10.3171/2008.4.17505