Before doing surgery patients should demand SRS to the tumor to reduce the risk of spread during surgery. Even with my large tumor, as I had a good response to dexamethasone to reduce swelling, SRS can be completed in one session if needed and it reduces the chance of spread.
NaSRS = neoadjuvant SRS, before surgery
"CONCLUSIONS: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong majority of patients were able to avoid WBRT. NaSRS merits consideration in a multi-institution trial."
A new treatment paradigm: neoadjuvant radiosurgery before surgical resection of brain metastases with analysis of local tumor recurrence.
http://www.ncbi.nlm.nih.gov/m/pubmed/24606851/