Twenty-four cases of surgery for solitary brain metastasis from lung cancer were clinically evaluated. After total or subtotal removal of the single metastasis, 87.5% of the patients had neurological improvement. However, in 43% of these 21 patients the improvement lasted no longer than 2 months. Also, one third of all patients lived for less than 5 months after surgery. The 2 patients who underwent intracranial surgery plus chemotherapy and radiation therapy for brain metastasis and also received radiation therapy plus chemotherapy or radical surgery plus chemotherapy for primary lung cancer survived somewhat longer. In 29% of the patients, death was caused mainly by regrowth of metastatic brain tumors shortly after intracranial surgery. In most of these cases the tumors were very large and cystic; thus, removal of both the cyst capsule and the solid portion may be a means of prolonging survival. Patients who also had metastases to bone and/or other organs had a poor outcome following intracranial surgery. This indicates that intracranial surgery for patients with extensive metastases is contraindicated.
