title: Predictors and survival in patients with melanoma brain metastases.
abstract: Brain metastases (BM) are one of the most frequent neurological complications of cancers. Melanoma is the third most common tumor to metastasize to the brain with a reported incidence of 10-40 %, and many patients have subclinical BM (>73 %). We computer-searched the clinical records of all our patients registered into a database to identify patients that presented or developed BM. A total of 49 patients with melanoma BM were included in our analysis. General time to brain metastases (TTBM) was 23 months. The nonparametric test between TTBM and the single variables showed an association between TTBM and Breslow thickness (p < 0.0076; Spearman's coefficient-0.411), ulceration (p = 0.0656; Spearman's coefficient-0.287) and positive sentinel lymph node (p < 0.0015; Spearman's coefficient-0.475). Performing multiple regression, positive SLN remained the only, statistically significant, predictive variable (p < 0.01). Regarding the first melanoma site, the axial sites were more likely to develop BM than peripheral ones (p < 0.001). The analysis of brain metastasis survival (BMS) with Kaplan-Meier curves has resulted in a median survival rate of 6 months (range 1-134 months) and was strongly related to response to treatment, number of parenchymal lesions, presence or absence of symptoms. The results of the current analysis revealed clinical and primary tumor characteristics associated with the development of BM, TTBM, and BMS. The SNL was found to be the strongest predictor for BM development.
authors: University Magna Graecia, V.le Europa, 88100 Catanzaro, Italy. ugobottoni@unicz.it
authors: Ugo
authors: U
authors: Bottoni
authors: Rita
authors: R
authors: Clerico
authors: Giovanni
authors: G
authors: Paolino
authors: Marina
authors: M
authors: Ambrifi
authors: Paola
authors: P
authors: Corsetti
authors: Stefano
authors: S
authors: Calvieri
mesh_terms: D001932:Brain Neoplasms / Q000401:mortality* / Q000556:secondary*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000556:secondary*; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*
references: Neuro Oncol. 2008 Apr;10(2):199-207
references: 18287337
references: J Neurosurg. 2002 Mar;96(3):552-8
references: 11883841
references: Cancer Res. 1983 Jul;43(7):3427-33
references: 6850649
references: Cancer. 2011 Apr 15;117(8):1697-703
references: 21472716
references: Curr Oncol Rep. 2012 Feb;14(1):63-9
references: 22006097
references: Eur J Cancer. 1998 Jul;34(8):1187-92
references: 9849477
references: J Clin Oncol. 2004 Jul 15;22(14):2865-72
references: 15254054
references: Br J Cancer. 2010 Apr 13;102(8):1213-8
references: 20372154
references: J Neurol Neurosurg Psychiatry. 1996 Aug;61(2):143-50
references: 8708681
references: J Exp Clin Cancer Res. 2011 Jan 18;30:10
references: 21244695
references: J Neurooncol. 2012 May;108(1):109-14
references: 22311106
references: Curr Probl Cancer. 2011 Jul-Aug;35(4):200-10
references: 21911183
references: Am J Clin Oncol. 2010 Dec;33(6):633-6
references: 20042969
references: Am J Surg. 1978 Jun;135(6):807-10
references: 665907
references: J Neurosurg. 1998 Jan;88(1):11-20
references: 9420067
references: J Neurosurg. 2000 Jul;93(1):9-18
references: 10883899
references: Ann Surg Oncol. 2000 Mar;7(2):87-97
references: 10761786
references: Cancer. 2011 Apr 15;117(8):1687-96
references: 20960525
references: Curr Oncol Rep. 2012 Feb;14(1):48-54
references: 22012633
references: Cancer. 1984 Jun 1;53(11):2550-2
references: 6713349
references: BMC Cancer. 2011 Sep 19;11:395
references: 21929800
references: Cancer. 1988 May 1;61(9):1926-34
references: 3355984
references: Cancer. 2007 Jan 15;109(2):306-12
references: 17149755
references: J Clin Oncol. 2004 Apr 1;22(7):1293-300
references: 15051777
references: Jpn J Clin Oncol. 2005 Sep;35(9):507-13
references: 16120623
references: ISRN Surg. 2011;2011:276908
references: 22084751
references: Semin Surg Oncol. 1996 Nov-Dec;12(6):429-35
references: 8914207
references: Cancer. 2011 Apr 15;117(8):1711-20
references: 21472718
references: Am J Clin Oncol. 2003 Aug;26(4):354-7
references: 12902884
references: Cancer. 2002 Apr 15;94(8):2265-72
references: 12001126
references: Onkologie. 2004 Apr;27(2):145-9
references: 15138346