Laser interstitial thermal therapy (LITT) is increasingly showing up in the histories of patients we're asked to treat with brain tumors and brain metastases. It can be used to ablate tumors, but it can also be used for radiation necrosis. This LAANTERN registry analysis of 787 patients is the largest prospective look at it. Median stay was 32.4 hours with a 12.8% adverse event rate and 0.25% surgical mortality. In newly diagnosed GBM, those able to have ablation of >90% of tumor had superior survival. In recurrent brain metastases, there was also improved survival among those able to have complete ablation. The latter is important to consider in referring patients earlier rather than later for LITT. This is registry data with no control arm, sub-50% one-year follow-up, and lesion volumes that differ threefold across ablation categories, so read the extent-of-ablation curves as selection as much as effect. | Leuthardt, J Clin Oncol 2026
