Patients with solitary brain metastases. Patients who have demonstrated a large brain metastases that is causing symptoms along with several other smaller brain metastases that may or may not be symptomatic.

The removal of a metastasis should provide the patient with an improvement in the function that was affected. When combined with other treatments such as radiation, surgery may provide the patient a vastly improved quality of life and in special cases survival as long as no other metastatic sites develop.

There has been a lot of interest in identifying which patients are best suited for surgery. It has been shown that patients who are active and have a Karnofsky's Performance Status greater than 70 (see KPS chart), who have no other sites of active disease other than the metastases in the brain, and who are less than 65 years old, have on the whole the best chance for improved survival and function following surgery.