{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:30:03Z","timestamp":1793694603572,"version":"4.5.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s11060-026-05819-6","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:53:05Z","timestamp":1791449585000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification for unfavorable outcome after resection of selected brain metastases in patients with multiple brain metastases"],"prefix":"10.1007","volume":"180","author":[{"given":"Thomas","family":"Eibl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra Andreea","family":"Mercea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Liebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Ritter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Rossmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwin","family":"Rezai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Moskwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Hurtig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Wunderlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Feldheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Liman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph J.","family":"Griessenauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Michael","family":"Schebesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"2","key":"5819_CR1","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1056\/NEJM200101113440207","volume":"344","author":"LM DeAngelis","year":"2001","unstructured":"DeAngelis LM (2001) Brain tumors. N Engl J Med 344(2):114\u2013123","journal-title":"N Engl J Med"},{"issue":"2","key":"5819_CR2","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s11060-024-04739-7","volume":"169","author":"TF Ersoy","year":"2024","unstructured":"Ersoy TF, Brainman D, Coras R, Berger B, Weissinger F, Grote A et al (2024) Defining the role of surgery for patients with multiple brain metastases. J Neurooncol 169(2):317\u2013328","journal-title":"J Neurooncol"},{"issue":"3","key":"5819_CR3","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/s11060-023-04242-5","volume":"161","author":"AL Potthoff","year":"2023","unstructured":"Potthoff AL, Heimann M, Lehmann F, Ilic I, Paech D, Borger V et al (2023) Survival after resection of brain metastasis: impact of synchronous versus metachronous metastatic disease. J Neurooncol 161(3):539\u2013545","journal-title":"J Neurooncol"},{"key":"5819_CR4","doi-asserted-by":"crossref","unstructured":"Proescholdt MA, Sch\u00f6del P, Doenitz C, Pukrop T, H\u00f6hne J, Schmidt NO et al (2021) The management of brain metastases-systematic review of neurosurgical aspects. Cancers (Basel) 13(7):1616","DOI":"10.3390\/cancers13071616"},{"issue":"2","key":"5819_CR5","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2023.5.FOCUS23197","volume":"55","author":"KM Schebesch","year":"2023","unstructured":"Schebesch KM, Hohne J, Noeva E, Pukrop T, Araceli T, Schmidt NO et al (2023) Brain metastasis resection: the impact of fluorescence guidance (MetResect study). Neurosurg Focus 55(2):E10","journal-title":"Neurosurg Focus"},{"key":"5819_CR6","doi-asserted-by":"publisher","first-page":"1149628","DOI":"10.3389\/fonc.2023.1149628","volume":"13","author":"L Baumgart","year":"2023","unstructured":"Baumgart L, Aftahy AK, Anetsberger A, Thunstedt D, Wiestler B, Bernhardt D et al (2023) Brain metastases in the elderly - Impact of residual tumor volume on overall survival. Front Oncol 13:1149628","journal-title":"Front Oncol"},{"issue":"1","key":"5819_CR7","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1023\/A:1021262218151","volume":"61","author":"BE Pollock","year":"2003","unstructured":"Pollock BE, Brown PD, Foote RL, Stafford SL, Schomberg PJ (2003) Properly selected patients with multiple brain metastases may benefit from aggressive treatment of their intracranial disease. J Neurooncol 61(1):73\u201380","journal-title":"J Neurooncol"},{"key":"5819_CR8","doi-asserted-by":"publisher","first-page":"869764","DOI":"10.3389\/fonc.2022.869764","volume":"12","author":"AK Aftahy","year":"2022","unstructured":"Aftahy AK, Barz M, Lange N, Baumgart L, Thunstedt C, Eller MA et al (2022) The Impact of Postoperative Tumor Burden on Patients With Brain Metastases. Front Oncol 12:869764","journal-title":"Front Oncol"},{"issue":"1b","key":"5819_CR9","first-page":"573","volume":"20","author":"Y Iwadate","year":"2000","unstructured":"Iwadate Y, Namba H, Yamaura A (2000) Significance of surgical resection for the treatment of multiple brain metastases. Anticancer Res 20(1b):573\u2013577","journal-title":"Anticancer Res"},{"issue":"2","key":"5819_CR10","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s11060-019-03242-8","volume":"144","author":"Y Higuchi","year":"2019","unstructured":"Higuchi Y, Yamamoto M, Serizawa T, Sato Y, Shuto T, Akabane A et al (2019) Stereotactic radiosurgery in elderly patients with brain metastases: comparison with non-elderly patients using database of a multi-institutional prospective observational study (JLGK0901-Elderly). J Neurooncol 144(2):393\u2013402","journal-title":"J Neurooncol"},{"issue":"Suppl 1","key":"5819_CR11","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3171\/2016.7.GKS161459","volume":"125","author":"T Kawabe","year":"2016","unstructured":"Kawabe T, Yamamoto M, Sato Y, Yomo S, Kondoh T, Nagano O et al (2016) Gamma Knife radiosurgery for brain metastases from pulmonary large cell neuroendocrine carcinoma: a Japanese multi-institutional cooperative study (JLGK1401). J Neurosurg 125(Suppl 1):11\u201317","journal-title":"J Neurosurg"},{"issue":"3","key":"5819_CR12","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1159\/000489948","volume":"96","author":"S Matsunaga","year":"2018","unstructured":"Matsunaga S, Shuto T, Yamamoto M, Yomo S, Kondoh T, Kobayashi T et al (2018) Gamma Knife Radiosurgery for Metastatic Brain Tumors from Malignant Melanomas: A Japanese Multi-Institutional Cooperative and Retrospective Cohort Study (JLGK1501). Stereotact Funct Neurosurg 96(3):162\u2013171","journal-title":"Stereotact Funct Neurosurg"},{"key":"5819_CR13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3171\/2010.8.GKS10838","volume":"113","author":"T Serizawa","year":"2010","unstructured":"Serizawa T, Yamamoto M, Sato Y, Higuchi Y, Nagano O, Kawabe T et al (2010) Gamma Knife surgery as sole treatment for multiple brain metastases: 2-center retrospective review of 1508 cases meeting the inclusion criteria of the JLGK0901 multi-institutional prospective study. J Neurosurg 113:48\u201352","journal-title":"J Neurosurg"},{"issue":"4","key":"5819_CR14","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/S1470-2045(14)70061-0","volume":"15","author":"M Yamamoto","year":"2014","unstructured":"Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J et al (2014) Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol 15(4):387\u2013395","journal-title":"Lancet Oncol"},{"issue":"2","key":"5819_CR15","doi-asserted-by":"publisher","first-page":"64","DOI":"10.14791\/btrt.2013.1.2.64","volume":"1","author":"N Hong","year":"2013","unstructured":"Hong N, Yoo H, Gwak HS, Shin SH, Lee SH (2013) Outcome of surgical resection of symptomatic cerebral lesions in non-small cell lung cancer patients with multiple brain metastases. Brain Tumor Res Treat 1(2):64\u201370","journal-title":"Brain Tumor Res Treat"},{"issue":"4","key":"5819_CR16","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1007\/s10072-017-3220-2","volume":"39","author":"M Salvati","year":"2018","unstructured":"Salvati M, Tropeano MP, Maiola V, Lavalle L, Brogna C, Colonnese C et al (2018) Multiple brain metastases: a surgical series and neurosurgical perspective. Neurol Sci 39(4):671\u2013677","journal-title":"Neurol Sci"},{"issue":"1","key":"5819_CR17","first-page":"vdac176","volume":"4","author":"A Ramos","year":"2022","unstructured":"Ramos A, Giantini-Larsen A, Pannullo SC, Brandmaier A, Knisely J, Magge R et al (2022) A multidisciplinary management algorithm for brain metastases. Neurooncol Adv 4(1):vdac176","journal-title":"Neurooncol Adv"},{"issue":"2","key":"5819_CR18","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/jns.1993.79.2.0210","volume":"79","author":"RK Bindal","year":"1993","unstructured":"Bindal RK, Sawaya R, Leavens ME, Lee JJ (1993) Surgical treatment of multiple brain metastases. J Neurosurg 79(2):210\u2013216","journal-title":"J Neurosurg"},{"issue":"1","key":"5819_CR19","doi-asserted-by":"publisher","first-page":"79","DOI":"10.4103\/0973-1482.131390","volume":"10","author":"A Agnoletti","year":"2014","unstructured":"Agnoletti A, Mencarani C, Panciani PP, Buffoni L, Ronchetti G, Spena G et al (2014) Surgery in cerebral metastases: are numbers so important? J Cancer Res Ther 10(1):79\u201383","journal-title":"J Cancer Res Ther"},{"issue":"3","key":"5819_CR20","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s00701-012-1606-8","volume":"155","author":"G Schackert","year":"2013","unstructured":"Schackert G, Lindner C, Petschke S, Leimert M, Kirsch M (2013) Retrospective study of 127 surgically treated patients with multiple brain metastases: indication, prognostic factors, and outcome. Acta Neurochir (Wien) 155(3):379\u2013387","journal-title":"Acta Neurochir (Wien)"},{"issue":"2","key":"5819_CR21","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s11060-024-04744-w","volume":"169","author":"S Niedermeyer","year":"2024","unstructured":"Niedermeyer S, Schmutzer-Sondergeld M, Weller J, Katzendobler S, Kirchleitner S, Forbrig R et al (2024) Neurosurgical resection of multiple brain metastases: outcomes, complications, and survival rates in a retrospective analysis. J Neurooncol 169(2):349\u2013358","journal-title":"J Neurooncol"},{"issue":"20","key":"5819_CR22","doi-asserted-by":"publisher","first-page":"7503","DOI":"10.1002\/cam4.3402","volume":"9","author":"P Sch\u00f6del","year":"2020","unstructured":"Sch\u00f6del P, J\u00fcnger ST, Wittersheim M, Reinhardt HC, Schmidt NO, Goldbrunner R et al (2020) Surgical resection of symptomatic brain metastases improves the clinical status and facilitates further treatment. Cancer Med 9(20):7503\u20137510","journal-title":"Cancer Med"},{"issue":"2","key":"5819_CR23","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1055\/s-0037-1601874","volume":"79","author":"AR Antu\u00f1a","year":"2018","unstructured":"Antu\u00f1a AR, Vega MA, Sanchez CR, Fernandez VM (2018) Brain Metastases of Non-Small Cell Lung Cancer: Prognostic Factors in Patients with Surgical Resection. J Neurol Surg Cent Eur Neurosurg 79(2):101\u2013107","journal-title":"J Neurol Surg Cent Eur Neurosurg"},{"issue":"8","key":"5819_CR24","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/S1470-2045(17)30414-X","volume":"18","author":"A Mahajan","year":"2017","unstructured":"Mahajan A, Ahmed S, McAleer MF, Weinberg JS, Li J, Brown P et al (2017) Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol 18(8):1040\u20131048","journal-title":"Lancet Oncol"},{"issue":"2","key":"5819_CR25","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1200\/JCO.2010.30.1655","volume":"29","author":"M Kocher","year":"2011","unstructured":"Kocher M, Soffietti R, Abacioglu U, Villa S, Fauchon F, Baumert BG et al (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952\u201326001 study. J Clin Oncol 29(2):134\u2013141","journal-title":"J Clin Oncol"},{"key":"5819_CR26","doi-asserted-by":"publisher","first-page":"1343500","DOI":"10.3389\/fonc.2023.1343500","volume":"13","author":"M Goldberg","year":"2023","unstructured":"Goldberg M, Mondragon-Soto MG, Altawalbeh G, Baumgart L, Gempt J, Bernhardt D et al (2023) Enhancing outcomes: neurosurgical resection in brain metastasis patients with poor Karnofsky performance score - a comprehensive survival analysis. Front Oncol 13:1343500","journal-title":"Front Oncol"},{"issue":"6","key":"5819_CR27","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.3171\/2021.7.JNS211172","volume":"136","author":"ST J\u00fcnger","year":"2022","unstructured":"J\u00fcnger ST, Reinecke D, Meissner AK, Goldbrunner R, Grau S (2022) Resection of symptomatic non-small cell lung cancer brain metastasis in the setting of multiple brain metastases. J Neurosurg 136(6):1576\u20131582","journal-title":"J Neurosurg"},{"issue":"5","key":"5819_CR28","doi-asserted-by":"publisher","first-page":"8708","DOI":"10.3390\/ijms14058708","volume":"14","author":"P Sch\u00f6del","year":"2013","unstructured":"Sch\u00f6del P, Schebesch KM, Brawanski A, Proescholdt MA (2013) Surgical resection of brain metastases-impact on neurological outcome. Int J Mol Sci 14(5):8708\u20138718","journal-title":"Int J Mol Sci"},{"issue":"5","key":"5819_CR29","first-page":"1021","volume":"56","author":"SH Paek","year":"2005","unstructured":"Paek SH, Audu PB, Sperling MR, Cho J, Andrews DW (2005) Reevaluation of surgery for the treatment of brain metastases: review of 208 patients with single or multiple brain metastases treated at one institution with modern neurosurgical techniques. Neurosurgery 56(5):1021\u20131034 discussion\u2009\u2013\u200934","journal-title":"Neurosurgery"},{"issue":"5","key":"5819_CR30","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.3171\/2019.1.JNS183085","volume":"132","author":"T Serizawa","year":"2020","unstructured":"Serizawa T, Yamamoto M, Higuchi Y, Sato Y, Shuto T, Akabane A et al (2020) Local tumor progression treated with Gamma Knife radiosurgery: differences between patients with 2\u20134 versus 5\u201310 brain metastases based on an update of a multi-institutional prospective observational study (JLGK0901). J Neurosurg 132(5):1480\u20131489","journal-title":"J Neurosurg"},{"key":"5819_CR31","doi-asserted-by":"crossref","unstructured":"Proescholdt M, J\u00fcnger ST, Sch\u00f6del P, Schebesch KM, Doenitz C, Pukrop T et al (2021) Brain metastases in elderly patients-the role of surgery in the context of systemic treatment. Brain Sci 11(1):123","DOI":"10.3390\/brainsci11010123"},{"issue":"1","key":"5819_CR32","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/COC.0000000000000477","volume":"42","author":"JP Leone","year":"2019","unstructured":"Leone JP, Haraldsson B, Mott SL, McDowell BD, Chrischilles EA (2019) Treatment Patterns and Survival of Elderly Patients With Breast Cancer Brain Metastases. Am J Clin Oncol 42(1):60\u201366","journal-title":"Am J Clin Oncol"},{"issue":"1","key":"5819_CR33","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jocn.2010.03.046","volume":"18","author":"AM Stark","year":"2011","unstructured":"Stark AM, St\u00f6hring C, Hedderich J, Held-Feindt J, Mehdorn HM (2011) Surgical treatment for brain metastases: Prognostic factors and survival in 309 patients with regard to patient age. J Clin Neurosci 18(1):34\u201338","journal-title":"J Clin Neurosci"},{"issue":"2","key":"5819_CR34","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s10143-004-0364-3","volume":"28","author":"AM Stark","year":"2005","unstructured":"Stark AM, Tscheslog H, Buhl R, Held-Feindt J, Mehdorn HM (2005) Surgical treatment for brain metastases: prognostic factors and survival in 177 patients. Neurosurg Rev 28(2):115\u2013119","journal-title":"Neurosurg Rev"},{"issue":"7","key":"5819_CR35","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1002\/cam4.439","volume":"4","author":"JP Leone","year":"2015","unstructured":"Leone JP, Lee AV, Brufsky AM (2015) Prognostic factors and survival of patients with brain metastasis from breast cancer who underwent craniotomy. Cancer Med 4(7):989\u2013994","journal-title":"Cancer Med"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-026-05819-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-026-05819-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-026-05819-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:14:08Z","timestamp":1793693648000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-026-05819-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["5819"],"URL":"https:\/\/doi.org\/10.1007\/s11060-026-05819-6","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"value":"0167-594X","type":"print"},{"value":"1573-7373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"12 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"9"}}