Postoperative functional status as the primary determinant of survival in surgically treated brain metastases: A retrospective cohort analysis
Aim: Brain metastases (BM) are an increasing oncological challenge due to improved systemic cancer survival. Surgical resection is essential for symptom control and diagnosis; however, survival outcomes remain heterogeneous. The objective of the current investigation was to evaluate the clinical and surgical determinants that impact overall survival (OS) outcomes in a cohort of patients undergoing resection for BM.Material and Methods: A total of 158 adult cases treated surgically for intracranial metastases from January 2018 to December 2024 were systematically analyzed through a retrospective institutional review. Demographic, clinical, radiological, and surgical variables were analyzed. OS was the primary endpoint. The Kaplan-Meier method was utilized for survival estimation, while the influence of various covariates on prognosis was examined through Cox proportional hazards modeling. The Tarone-Ware test was used to assess early survival differences. Results: Our analysis revealed a median survival time of 6.0 months. Initial univariable screening showed that survival was significantly linked to factors such as patient age, gender, adjuvant therapies, and KPS measured at different perioperative stages. In the revised multivariable analysis, postoperative KPS (HR: 0.974, 95% CI: 0.962-0.986, p