Solitary cerebral metastasis: the effect of craniotomy on the quality and the duration of survival.

The authors report 57 patients in whom craniotomies for solitary intracranial metastatic tumor were performed in Vancouver General Hospital between 1970 and 1980. The median survival after craniotomy varied between 3.5 and 10 months depending upon the types of primary tumors. Patients with metastatic central nervous system (CNS) tumor from breast, kidney, or an unknown primary site had longer periods of survival than those with bronchogenic carcinoma. The outcome for metastatic melanoma was poor. Eighty-two per cent of the patients were able to enjoy home life and were self-dependent at the time of discharge from the hospital. A long latent interval between the primary tumor diagnosis and secondary CNS metastasis favored longer survival for patients with bronchogenic carcinoma, but not for those with melanoma. The presence of systemic metastases was an adverse factor. There was no significant difference in the duration of survival between patients with right- or left-sided cerebral lesions, but those with right hemispheric involvement had a better quality of survival. The use of computed tomographic scanning improved both the duration and the quality of postoperative survival.