Outcome

Overall, the prognosis is poor for patients with brain metastases from the common cancers. For patients with poor prognostic features, the median survival may be only 6-8 weeks, irrespective of treatment. At the opposite end, patients with 'good prognosis', solitary metastases

Table 25.4 Prognostic factors for patients with brain metastases

Factor

Description

Influence

Age

Increasing age (>50)

Adverse

Performance status

Poor general condition

Adverse

Fixed neurological deficit

Adverse

Histology

Adenocarcinoma

Favourable

Squamous (esp. lung)

Adverse

Germ cell

Very favourable

Number

Solitary

Favourable

Multiple

Adverse

Size

Small

Favourable

Large

Unfavourable

Operability

Resectable

Favourable

that are adequately treated with surgery and radiotherapy enjoy a much better outlook, with many surviving two years or more.

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