Use of neuroendoscopy in metastatic brain tumours: A systematic review

Neuroendoscopy allows the performance of biopsy and the resection of metastatic brain lesions using a minimally invasive approach. The present systematic review aimed to survey the existing evidence surrounding the use of neuroendoscopic techniques in the setting of metastatic brain lesions. A systematic search of the available literature was performed using the approach outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The search identified 34 studies that enrolled 150 participants. The average age of the patients was 57 years (range, 37-80 years), and the female-to-male ratio was 51 to 54. The most common primary sites were the lung (42/113), breast (18/113) and melanoma (16/113). Supratentorial tumours represented 93 of the 115 cases. Of the 34 included studies, the goal of the procedure was resection in 23 studies, biopsy in six studies (with ventriculostomy in 3), and both in five studies. The degree of resection was reported for 93 participants, in which a gross, near and subtotal resection was achieved in 60, 13 and 20 cases, respectively. Overall, 13 studies encompassing 34 participants reported that 28 (82%) patients demonstrated post-operative symptomatic improvement following resection. The overall survival was reported for 50 patients following resection across four studies, yielding a weighted average of 12.8 months. To the best of our knowledge, the present study represents the first comprehensive systematic assessment of the existing evidence surrounding the role of neuroendoscopy for brain metastases. The findings presented herein demonstrate promise for the role of neuroendoscopy in this setting; however, the quality and quantity of evidence limit the drawing of strong conclusions.