{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:35:01Z","timestamp":1784162101642,"version":"3.55.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Systemic therapeutic advancements have improved the prognosis of cancer patients, leading to surgery more frequently being carried out for patients with multiple brain metastases (BM). The underlying evidence for the strategy is currently lacking. This study aimed to evaluate the prognostic significance of the number of BM and total tumor burden (TTB) on the overall survival (OS) of patients with resected BM of non\u2013small cell lung cancer (NSCLC) in a modern series.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>In this monocentric retrospective series, patients who underwent resection of BM of NSCLC between 2015 and 2021 were included. Demographic, clinical, and histological parameters were collected, and formal radiological volumetric analyses were performed. Prognostic biomarkers for cerebral progression-free survival (C-PFS) and OS were analyzed with univariate and multivariate Cox proportional hazards analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>One hundred eighty-four patients were included in the study. Among these, 108 patients (58.7%) presented with a single brain metastasis, 36 patients (19.6%) with 2 BM, 22 patients (11.9%) with 3 BM, and 18 patients (9.8%) with more than 3 BM (maximum 15 BM). The mean \u00b1 SD (range) preoperative tumor burden was 23.1 \u00b1 25.3 (1.1\u2013145.3) cm<jats:sup>3<\/jats:sup>. The mean residual tumor burden after surgery was 0.3 \u00b1 0.8 (0.0\u20136.3) cm<jats:sup>3<\/jats:sup>. By the time of the analysis, 128 patients (69.6%) had died. The median follow-up duration was 49.0 months (95% CI 39.6\u201363.6). The median OS was 19.2 months (95% CI 13.2\u201324.0), and the survival rates at 6 months, 1 year, and 2 years were 76% (95% CI 69%\u201382%), 61% (95% CI 53%\u201367%), and 43% (95% CI 35%\u201350%), respectively. The median C-PFS was 8.4 months (95% CI 7.2\u201312.0). In the Cox multivariate regression model, younger age (&lt; 65 years), single brain metastasis, adjuvant brain radiation therapy, adjuvant use of targeted therapy, and TTB &lt; 7 cm<jats:sup>3<\/jats:sup> were all independent predictors of longer OS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In this era of modern systemic treatments for cancer, the number of BM and total cerebral tumor burden remain significant prognostic factors of OS. However, resection should be considered as an option even in those patients with multiple BM in order to enhance patient clinical status, enable further local and systemic treatment delivery, and improve their survival and quality of life.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.11.jns231923","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T01:19:04Z","timestamp":1705713544000},"page":"89-99","source":"Crossref","is-referenced-by-count":9,"title":["Prognostic impact of the number and total tumor burden of secondary cerebral lesions in patients with resected brain metastases of non\u2013small cell lung cancers"],"prefix":"10.3171","volume":"141","author":[{"given":"Sidonie","family":"Sauvageot","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gui de Chauliac University Hospital, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Mollevi","sequence":"additional","affiliation":[{"name":"Desbrest Institute of Epidemiology and Public Health, INSERM, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin D.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Montpellier Cancer Institute (ICM), Montpellier, France;"},{"name":"Oncogenic Pathways in Lung Cancer, Montpellier Cancer Research Institute (IRCM), INSERM U1194, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Charissoux","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Montpellier Cancer Institute (ICM), Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Am\u00e9lie","family":"Darlix","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Montpellier Cancer Institute (ICM), Montpellier, France;"},{"name":"Institute of Functional Genomics, Montpellier University CNRS, INSERM U1191, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Rigau","sequence":"additional","affiliation":[{"name":"Institute of Functional Genomics, Montpellier University CNRS, INSERM U1191, Montpellier, France;"},{"name":"Department of Pathology and Onco-biology, Gui de Chauliac University Hospital, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Bauchet","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gui de Chauliac University Hospital, Montpellier, France;"},{"name":"Institute of Functional Genomics, Montpellier University CNRS, INSERM U1191, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Quantin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Oncology, Montpellier Cancer Institute (ICM), Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Louis","family":"Pujol","sequence":"additional","affiliation":[{"name":"Thoracic Oncology Unit, University Hospital of Montpellier, Montpellier, France; and"},{"name":"Cancerology Research Institute of Montpellier (IRCM), National Institute for Health and Medical Research (INSERM) Unit-U1194, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Roch","sequence":"additional","affiliation":[{"name":"Thoracic Oncology Unit, University Hospital of Montpellier, Montpellier, France; and"},{"name":"Cancerology Research Institute of Montpellier (IRCM), National Institute for Health and Medical Research (INSERM) Unit-U1194, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Boetto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gui de Chauliac University Hospital, Montpellier, France;"},{"name":"Institute of Functional Genomics, Montpellier University CNRS, INSERM U1191, Montpellier, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Health Organization","article-title":"Cancer","unstructured":"Cancer. 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