Surgical Resection of Latent Brain Tumors Prior to Recurrence

This clinical trial evaluates the side effects and possible benefits of operating on brain tumors prior to the tumor coming back (recurrence). Understanding when surgery is most useful to patients with brain tumors is important. Some patients may undergo chemotherapy or radiation but still have visible tumor remaining after treatment. The purpose of this research is to compare outcomes of those who have surgery after chemotherapy or radiation, but prior to tumor recurrence, to those who have surgery at a different time, or no surgery at all.

Inclusion Criteria: * Age \>= 18 years * Histological or cytological confirmation of brain tumor and/or suspected brain tumor based on clinical and radiologic findings * Prior chemotherapy and/or radiation treatment directed to the known/suspected tumor * Radiographic evidence of residual or previously unresected tumor * Willingness to undergo surgery and sign informed consent * Patients not currently eligible for an alternate competing interventional clinical trial * Enrollment in the Mayo Clinic Cancer Center Neuro-Oncology Program Registry for the study of Nervous System Tumors (IRB#12-003458) Exclusion Criteria: * Age \< 18 years * Found to be a member of a vulnerable population (e.g. pregnant, lacking capacity to consent) during the course of pre-enrollment or pre-surgical assessment * Prior gross total resection of brain tumor leading to absence of visible latent disease (exemption available for post-operative enrollment) * Any contraindication to surgery, including anyone who in the opinion of the surgeon is at unreasonably elevated risk of wound complications * Patients who have not yet undergone surgery or radiation, but who would be appropriate candidates for an alternate interventional clinical trial (e.g. post-operative fractionated vs single fraction radiation to the surgical cavity for surgical brain metastases)