title: Prognostic factors and impact of treatment in melanoma brain metastases: better prognosis for women?
abstract: BACKGROUND
  Brain metastases are a common consequence in patients with stage IV melanoma associated with a grim prognosis.
  
  
  OBJECTIVE
  The objective of this study was the examination of prognostic factors and the evaluation of different treatment options.
  
  
  METHODS
  A consecutive series of 133 patients with melanoma brain metastases with regard to prognostic factors and the impact on survival were analyzed.
  
  
  RESULTS
  82 patients had involvement of only the cerebrum at the initial diagnosis, whereas in 7 patients only the cerebellum and the brainstem were involved. Seizures (n = 29) were the single most often reported symptom. The overall median survival time was 24 weeks (1-196) from diagnosis of brain metastases. Women had a significantly longer survival with 36 weeks (3-196) compared to 17 weeks (1-159) for men. Multivariate analysis has established as significant prognostic factors: female gender, number of brain metastases, surgery, chemotherapy, radiotherapy and corticosteroid application.
  
  
  CONCLUSIONS
  With regard to the prognostic factors, an improved survival can be achieved in this patient group using more elective treatment options, also with emphasis on corticosteroids.
authors.affiliation: Department of Dermatology and Allergy, Skin Cancer Centre, Charité Universitatsmedizin Berlin, Berlin, Germany. maja.hofmann@charite.de
authors.forename: Maja A
authors.initials: MA
authors.lastname: Hofmann
authors.forename: Stefanie Hernandez
authors.initials: SH
authors.lastname: Coll
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Küchler
authors.forename: Felix
authors.initials: F
authors.lastname: Kiecker
authors.forename: Reinhard
authors.initials: R
authors.lastname: Wurm
authors.forename: Wolfram
authors.initials: W
authors.lastname: Sterry
authors.forename: Uwe
authors.initials: U
authors.lastname: Trefzer
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis