{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:18:22Z","timestamp":1787980702260,"version":"build-2784847793"},"reference-count":15,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Surgery for brain metastases (BM) is embedded in a multidisciplinary oncologic pathway. This study evaluated oncologic readiness and return to intended oncologic therapy (RIOT) after surgery for BM. Patients undergoing surgery for histologically confirmed BM were retrospectively identified. Oncologic readiness was defined as sufficient postoperative clinical and neurological recovery to allow the next indicated oncologic treatment. RIOT was defined as postoperative radiotherapy and\/or systemic treatment within 30 days after surgery. Exploratory analyses assessed factors associated with oncologic readiness and RIOT after readiness. Among 126 patients, oncologic readiness was achieved in 114 (90%) and RIOT in 99 (79%). Absence of oncologic readiness was associated with postoperative morbidity and persistent neurological deficit, whereas absence of RIOT after readiness showed no distinct clinical or BM-related profile. Change in patient preference, neurological or functional deterioration, and organizational delay were the most frequent reasons for no RIOT after readiness. Oncologic readiness distinguished patients with insufficient surgical recovery from those who recovered but did not proceed to further treatment. These findings support RIOT as a process endpoint for the transition from BM surgery to postoperative oncologic care.<\/jats:p>","DOI":"10.3390\/curroncol33090511","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:26:03Z","timestamp":1787837163000},"page":"511","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Return to Intended Oncologic Therapy After Brain Metastasis Surgery: Mapping the Early Postoperative Pathway"],"prefix":"10.3390","volume":"33","author":[{"given":"Alexis","family":"Hadjiathanasiou","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9427-2304","authenticated-orcid":false,"given":"Martin","family":"Liebisch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Dahn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8073-1625","authenticated-orcid":false,"given":"Johannes","family":"Lemcke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5806-2576","authenticated-orcid":false,"given":"Patrick","family":"Schuss","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ejca.2021.12.005","article-title":"Changing Characteristics, Treatment Approaches and Survival of Patients with Brain Metastasis: Data from Six Thousand and Thirty-One Individuals over an Observation Period of 30 Years","volume":"162","author":"Steindl","year":"2022","journal-title":"Eur. J. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fiore, G., Tariciotti, L., Bertani, G.A., Gagliano, D., D\u2019Ammando, A., Ampollini, A.M., Schisano, L., Borsa, S., Pluderi, M., and Locatelli, M. (2023). Surgery vs. Radiosurgery for Patients with Localized Metastatic Brain Disease: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Cancers, 15.","DOI":"10.3390\/cancers15153802"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1200\/JCO.21.02314","article-title":"Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline","volume":"40","author":"Vogelbaum","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1002\/cncr.32714","article-title":"Current Multidisciplinary Management of Brain Metastases","volume":"126","author":"Moravan","year":"2020","journal-title":"Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/s41571-019-0320-3","article-title":"Current Approaches to the Management of Brain Metastases","volume":"17","author":"Suh","year":"2020","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/jso.23626","article-title":"Return to Intended Oncologic Treatment (RIOT): A Novel Metric for Evaluating the Quality of Oncosurgical Therapy for Malignancy: Return to Adjuvant Therapy Post Cancer Surgery","volume":"110","author":"Aloia","year":"2014","journal-title":"J. Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1007\/s11605-019-04165-5","article-title":"Detours on the Road to Recovery: What Factors Delay Readiness to Return to Intended Oncologic Therapy (RIOT) After Liver Resection for Malignancy?","volume":"23","author":"Lillemoe","year":"2019","journal-title":"J. Gastrointest. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e2340654","DOI":"10.1001\/jamanetworkopen.2023.40654","article-title":"Outcomes Following Early Postoperative Adjuvant Radiosurgery for Brain Metastases","volume":"6","author":"Bander","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7503","DOI":"10.1002\/cam4.3402","article-title":"Surgical Resection of Symptomatic Brain Metastases Improves the Clinical Status and Facilitates Further Treatment","volume":"9","author":"Wittersheim","year":"2020","journal-title":"Cancer Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schuss, P., Sch\u00e4fer, N., Bode, C., Borger, V., Eichhorn, L., Giordano, F.A., Guresir, E., Heimann, M., Ko, Y.D., and Landsberg, J. (2021). The Impact of Prolonged Mechanical Ventilation on Overall Survival in Patients with Surgically Treated Brain Metastases. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.658949"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Schneider, M., Heimann, M., Schaub, C., Eichhorn, L., Potthoff, A.-L., Giordano, F.A., Guresir, E., Ko, Y.-D., Landsberg, J., and Lehmann, F. (2020). Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases. Cancers, 12.","DOI":"10.3390\/cancers12113209"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/CCO.0000000000000484","article-title":"The Role of Surgical Resection in Patients with Brain Metastases","volume":"30","author":"Carapella","year":"2018","journal-title":"Curr. Opin. Oncol."},{"key":"ref_13","first-page":"214","article-title":"Predictors of Neurological Outcomes after Resection of Brain Metastases: A Cohort Study and Classification for Patient Selection","volume":"145","author":"Wong","year":"2026","journal-title":"J. Neurosurg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e432","DOI":"10.1016\/S1470-2045(24)00198-0","article-title":"Defining the Quality of Interdisciplinary Care for Patients with Brain Metastases: Modified Delphi Panel Recommendations","volume":"25","author":"Fadul","year":"2024","journal-title":"Lancet Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1200\/OP.20.00233","article-title":"Genesis of Quality Measurements to Improve the Care Delivered to Patients with Brain Metastases","volume":"17","author":"Silvestre","year":"2021","journal-title":"JCO Oncol. Pract."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/511\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:31:39Z","timestamp":1787977899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/9\/511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":15,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["curroncol33090511"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33090511","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]}}}