title: Predictive factors for the development of brain metastases in patients with malignant melanoma: a study by the Anatolian society of medical oncology.
abstract: BACKGROUND
  The development of brain metastases (BMs) was associated with poor prognosis in melanoma patients. Patients with BMs have a median survival of <6 months. Melanoma is the third most common tumor to metastasize to the brain with a reported incidence of 10-40 %. Our aim was to identify factors predicting development of BMs and survival.
  
  
  METHODS
  We performed a retrospective analysis of 470 melanoma patients between 2000 and 2012. The logistic regression analyses were used to identify the clinicopathological features of primary melanoma that are predictive of BMs development and survival after a diagnosis of brain metastases.
  
  
  RESULTS
  There were 52 patients (11.1 %) who developed melanoma BMs during the study period. The analysis of post-BMs with Kaplan-Meier curves has resulted in a median survival rate of 4.1 months (range 2.9-5.1 months). On logistic regression analysis site of the primary tumor on the head and neck (p = 0.002), primary tumor thickness (Breslow >4 mm) (p = 0.008), ulceration (p = 0.007), and pathologically N2 and N3 diseases (p = 0.001) were found to be significantly associated with the development of BMs. In univariate analysis, tumor thickness and performance status had a significant influence on post-BMs survival. In multivariate analysis, these clinicopathologic factors were not remained as significant predictive factors.
  
  
  CONCLUSIONS
  Our results revealed the importance of primary tumor characteristics associated with the development of BMs. Ulceration, primary tumor thickness, anatomic site, and pathologic ≥N2 disease were found to be significant predictors of BMs development.
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Besevler, Ankara, 06500, Turkey, ozgebostankolu@hotmail.com.
authors.forename: Ozge
authors.initials: O
authors.lastname: Gumusay
authors.forename: Ugur
authors.initials: U
authors.lastname: Coskun
authors.forename: Tülay
authors.initials: T
authors.lastname: Akman
authors.forename: Ahmet Siyar
authors.initials: AS
authors.lastname: Ekinci
authors.forename: Muharrem
authors.initials: M
authors.lastname: Kocar
authors.forename: Ozlem Balvan
authors.initials: OB
authors.lastname: Erceleb
authors.forename: Ozan
authors.initials: O
authors.lastname: Yazıcı
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaplan
authors.forename: Veli
authors.initials: V
authors.lastname: Berk
authors.forename: Bulent
authors.initials: B
authors.lastname: Cetin
authors.forename: Burcu Yapar
authors.initials: BY
authors.lastname: Taskoylu
authors.forename: Ayhan
authors.initials: A
authors.lastname: Yildiz
authors.forename: Gamze
authors.initials: G
authors.lastname: Goksel
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alacacioglu
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Efnan
authors.initials: E
authors.lastname: Algin
authors.forename: Mukremin
authors.initials: M
authors.lastname: Uysal
authors.forename: Ilhan
authors.initials: I
authors.lastname: Oztop
authors.forename: Berna
authors.initials: B
authors.lastname: Oksuzoglu
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000556:secondary*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies