Early and Late Prognostic Factors in Patients with Resected Brain Metastases

Abstract

Simple Summary Brain metastases are among the most common intracranial tumors in adults, and outcomes after surgical treatment vary considerably among patients. This retrospective study analyzed 378 consecutive adults who underwent resection of histologically confirmed brain metastases at Bagdasar-Arseni Clinical Emergency Hospital between 2015 and 2023. Median overall survival was 11.3 months, and 18 patients died within 30 days after surgery. In multivariable analysis, poor preoperative functional status, hydrocephalus, postoperative hematoma, and postoperative pneumonia were associated with higher 30-day mortality. Increasing age, poor preoperative functional status, tumor volume ≥ 9 cm3, hydrocephalus, postoperative wound complications, and worsening functional status during the first postoperative week were independently associated with shorter overall survival. However, the tumor-volume finding should be interpreted cautiously because it depended on the selected cutoff. These findings highlight the importance of careful patient selection, preservation of functional status, optimization of perioperative care, and early prevention and management of postoperative complications. As this study included only surgically treated patients, its findings represent prognostic associations within this population and do not establish a survival benefit attributable to surgery itself.