Urological cancer metastasis to the brain: When should we resect?

Ronald S. Chamberlain, Zachary W A Klaassen, Faris Shweikeh

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Although metastasis from urological malignancies to the brain occur late in the disease process and are typically associated with a poor prognosis, prolonged survival and excellent quality of life is achievable in a small, select population of patients. Surgical management has historically been utilized with large brain metastases, resulting in rapid increases in intracranial pressure and/or severe neurological defcits; however, the indications for surgical resection in the nonemergent setting are less clear. Methods: The National Library of Medicine search engine PubMed was used to search for terms, including "brain metastasis, renal cell carcinoma," "brain metastasis, bladder cancer," "brain metastasis, prostate cancer," and "brain metastasis, nonseminomatous testicular germ cell tumors." Results: Patients with renal cell carcinoma who typically have well circumscribed, frm radio and chemoresistant brain metastasis and patients with nonseminomatous testicular germ cell tumors who are generally younger with synchronous brain metastasis should be considered for aggressive surgical resection. Patients with brain metastasis from bladder or prostate cancer have a poor overall prognosis, and surgical resection is typically used only to improve quality of life, if not marginally extend survival. Conclusion: Brain metastasis from urologic cancers are a late disease manifestation and surgical therapy is reserved for patients with a good Karnofsky Performance Status (> 70), minimal-to-no systemic disease, solitary large lesions (preferably > 3 cm), and those with a life expectancy of more than 3 months.

Original languageEnglish (US)
JournalUroToday International Journal
Volume5
Issue number2
DOIs
StatePublished - Apr 1 2012

Fingerprint

Urologic Neoplasms
Neoplasm Metastasis
Brain
Renal Cell Carcinoma
Urinary Bladder Neoplasms
Brain Neoplasms
Prostatic Neoplasms
Quality of Life
National Library of Medicine (U.S.)
Karnofsky Performance Status
Search Engine
Intracranial Hypertension
Survival
Life Expectancy
Radio
PubMed

Keywords

  • Bladder cancer
  • Brain metastasis
  • Nonseminomatous testicular germ cell tumors
  • Prostate cancer
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Urological cancer metastasis to the brain : When should we resect? / Chamberlain, Ronald S.; Klaassen, Zachary W A; Shweikeh, Faris.

In: UroToday International Journal, Vol. 5, No. 2, 01.04.2012.

Research output: Contribution to journalArticle

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