title: Single brain metastases from melanoma: remarks on a series of 84 patients.
abstract: The authors report on 84 patients with single melanoma brain metastasis surgically treated from 1997 to 2007. There were 46 males and 38 females; mean age was 41 years (range 24-58 years). All patients were surgically treated, and 52 of them received postoperative adjuvant therapy consisting of whole-brain radiation therapy (36), radiosurgery (9), or a combination of these two techniques (7). Brain recurrences were observed in 44 cases, of which 9 were local. Of the latter, seven were re-operated while the remaining two were treated by radiosurgery. At 1-year follow-up, the survival rate was 52% (32 patients) whereas only 12 patients (14%) were still alive after 2 years. None of the patients in which removal was subtotal survived for more than 6 months after surgical treatment. Three years after the onset of the brain metastasis, five patients (6%) were still alive. Survival was significantly influenced by treatment with regard to overall survival reported in other series. A review of literature, together with our own series, suggests that radical surgical treatment of the lesion possibly employing the internal no-touch technique has significantly increased survival in our patients (p < 0.05) and that the association of postoperative radiotherapy and re-operation in the event of recurrent metastatic lesions is advisable even though statistical significance was not reached (p > 0.05).
authors.affiliation: Neurosurgery INM-Neuromed, Pozzilli (IS), University of Rome Sapienza, Via Cardinal Agliardi 15, 00165 Rome, Italy. salvati.maurizio@libero.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Salvati
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frati
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Elia
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pescatori
authors.forename: Manolo
authors.initials: M
authors.lastname: Piccirilli
authors.forename: Andrea
authors.initials: A
authors.lastname: Pietrantonio
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fazi
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000328:Adult; D001921:Brain / Q000601:surgery; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D016634:Radiosurgery; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult