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The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline

Overview of attention for article published in Journal of Neuro-Oncology, December 2009
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#47 of 1,806)
  • High Attention Score compared to outputs of the same age (90th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
1 news outlet
blogs
1 blog

Citations

dimensions_citation
224 Dimensions

Readers on

mendeley
202 Mendeley
Title
The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline
Published in
Journal of Neuro-Oncology, December 2009
DOI 10.1007/s11060-009-0061-8
Pubmed ID
Authors

Steven N. Kalkanis, Douglas Kondziolka, Laurie E. Gaspar, Stuart H. Burri, Anthony L. Asher, Charles S. Cobbs, Mario Ammirati, Paula D. Robinson, David W. Andrews, Jay S. Loeffler, Michael McDermott, Minesh P. Mehta, Tom Mikkelsen, Jeffrey J. Olson, Nina A. Paleologos, Roy A. Patchell, Timothy C. Ryken, Mark E. Linskey

Abstract

Should patients with newly-diagnosed metastatic brain tumors undergo open surgical resection versus whole brain radiation therapy (WBRT) and/or other treatment modalities such as radiosurgery, and in what clinical settings? Target population These recommendations apply to adults with a newly diagnosed single brain metastasis amenable to surgical resection. Recommendations Surgical resection plus WBRT versus surgical resection alone Level 1 Surgical resection followed by WBRT represents a superior treatment modality, in terms of improving tumor control at the original site of the metastasis and in the brain overall, when compared to surgical resection alone. Surgical resection plus WBRT versus SRS +/- WBRT Level 2 Surgical resection plus WBRT, versus stereotactic radiosurgery (SRS) plus WBRT, both represent effective treatment strategies, resulting in relatively equal survival rates. SRS has not been assessed from an evidence-based standpoint for larger lesions (>3 cm) or for those causing significant mass effect (>1 cm midline shift). Level 3 Underpowered class I evidence along with the preponderance of conflicting class II evidence suggests that SRS alone may provide equivalent functional and survival outcomes compared with resection + WBRT for patients with single brain metastases, so long as ready detection of distant site failure and salvage SRS are possible. Note The following question is fully addressed in the WBRT guideline paper within this series by Gaspar et al. Given that the recommendation resulting from the systematic review of the literature on this topic is also highly relevant to the discussion of the role of surgical resection in the management of brain metastases, this recommendation has been included below. Question Does surgical resection in addition to WBRT improve outcomes when compared with WBRT alone? Target population This recommendation applies to adults with a newly diagnosed single brain metastasis amenable to surgical resection; however, the recommendation does not apply to relatively radiosensitive tumors histologies (i.e., small cell lung cancer, leukemia, lymphoma, germ cell tumors and multiple myeloma). Recommendation Surgical resection plus WBRT versus WBRT alone Level 1 Class I evidence supports the use of surgical resection plus post-operative WBRT, as compared to WBRT alone, in patients with good performance status (functionally independent and spending less than 50% of time in bed) and limited extra-cranial disease. There is insufficient evidence to make a recommendation for patients with poor performance scores, advanced systemic disease, or multiple brain metastases.

Mendeley readers

The data shown below were compiled from readership statistics for 202 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 7 3%
Japan 2 <1%
Spain 1 <1%
Belgium 1 <1%
Unknown 191 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 47 23%
Other 33 16%
Student > Postgraduate 27 13%
Student > Doctoral Student 19 9%
Professor > Associate Professor 19 9%
Other 57 28%
Readers by discipline Count As %
Medicine and Dentistry 142 70%
Unspecified 24 12%
Agricultural and Biological Sciences 10 5%
Neuroscience 7 3%
Engineering 4 2%
Other 15 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 September 2013.
All research outputs
#1,058,559
of 12,317,289 outputs
Outputs from Journal of Neuro-Oncology
#47
of 1,806 outputs
Outputs of similar age
#14,945
of 153,888 outputs
Outputs of similar age from Journal of Neuro-Oncology
#2
of 38 outputs
Altmetric has tracked 12,317,289 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,806 research outputs from this source. They receive a mean Attention Score of 2.8. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 153,888 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 38 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.