1st order
- Brain tumors: If possible, complete resection (surgical removal) of the tumor (by stereotaxy if necessary) [primary treatment of choice].
- Brain metastases* :
- In a limited number of one to three metastases,
- With a diameter of ≥ 3 cmNote: If a metastasis is not so extensive and has a size of ≤ 3-3.5 cm, the European guidelines recommend stereotactic radiosurgery, which can also be performed as an alternative to surgery.
- Metastases in the posterior fossa in space-occupying effect and compression of the 4th ventricle with resulting hydrocephalus occlusus (occlusive hydrocephalus).
* Note: The infiltration zone of brain metastases, according to current knowledge, is in a range of up to 5 mm.
Further notes
- Patients with low-grade glioma benefit more from surgery than from watchful waiting in the long term: overall survival was 5.8 years (95% confidence interval: 4.5-7.2 years) in the watchful waiting group and 14.4 years (95% confidence interval: 10.4-18.5 years) in the surgery group.
