Clinical presentation, treatment and outcome of patients with cerebral metastases: the University of São Paulo series

Secondary neoplasias are the most common tumors affecting the central nervous system and several clinical aspects of this disease are still controversial. Forty-seven consecutive patients with the diagnosis of cerebral metastases (CM) were retrospectively studied at the Clinical Hospital of Sao Paulo University Medical School. Mean age was 53.9 years and 25 patients were female. The most frequent primary sites were breast, lung and skin. Symptoms were related to increased intracranial pressure (ICP) in 48.9%, focal neurological events in 27.7% and both in 17.0%. Single brain metastases were found in 57.4% of those cases, the frontal lobe being most frequently affected. Surgical treatment was performed in 68.1%, radiotherapy in 40.4% and chemotherapy in 17.0%. After statistical analysis, there was a trend towards prolonged survival of female patients, patients with ICP symptoms and the surgical group. Data from different centers are essential to establish the best management of CM.