On the issue of indications for surgical treatment of metastases of malignant tumors in the brain
Among the many undesirable consequences of systemic cancer, it is its metastatic spread to the brain that contributes to the subsequent detrimental effect on many of the most important functions controlled by this organ. Brain metastasis is a defining sign of poor prognosis and almost always precedes death in patients with malignant solid tumors. Currently, there are no effective measures to reliably prevent this event, and early confirmation of the presence of brain metastases is crucial for any specific intervention in this clinical situation to help minimize irreversible damage to the nervous system. The selective use of radiotherapy and surgical intervention is the main method of treating many metastatic brain lesions, especially if they become symptomatic. However, these methods have many limitations depending on the localization and features of the tumor process, as well as in connection with acute and delayed side effects of its manifestation. In order to maximize the probability of a favorable outcome with any kind of special therapeutic effect on the metastases of malignant tumors in the brain, including their surgical treatment, proper selection of patients is extremely important. In this article, the author presents his own opinion on the definition of a number of prognostic signs aimed at identifying the most appropriate tactics of special treatment, primarily surgical, metastases of malignant tumors in the brain.