Further points to consider regarding the resection strategy of eloquent brain metastasis in the era of postoperative stereotactic radiotherapy.

Abstract

Häni et al. present an important analysis evaluating outcomes following resection of eloquent brain metastases without surgical margins in the context of postoperative stereotactic radiotherapy. While their findings support functional preservation without compromising local control, we believe several clinical nuances warrant further discussion. In this letter, we address the heterogeneity of tumor histologies, highlight the potential of upfront SRS in select small, eloquent lesions, and draw parallels to established strategies in benign intracranial tumors. These considerations may help refine treatment paradigms for patients with eloquent brain metastases.