Risk factors for early death after surgery in patients with brain metastases: reevaluation of the indications for and role of surgery

Surgical resection remains an important option for the treatment of brain metastases despite recent advancements in radiotherapy and systemic therapy. When selecting surgical candidates, it is important to exclude terminal cases who will receive neither a survival benefit nor an improvement in their quality of life. We reviewed a total of 264 surgical cases of brain metastases and analyzed the clinical characteristics of early death in order to clarify the indication for and the role of surgery. The median survival time (MST) after surgery in all cases was 12.4 months. Early death was defined as death within 6 months, and 23 % (62 cases) of this series were succumbed to this. A decrease in postoperative Karnofsky performance status (KPS) (