Distance from Primary Tumor Is the Strongest Predictor for Early Onset of Brain Metastases in Melanoma.
OBJECTIVE
The frequency of brain metastasis (BM) is up to 45-50% in patients with advanced melanoma. Our aim was to identify the risk factors for the early occurrence of BM.


METHODS
A total of 333 patients with BM were identified from our database of 2,972 patients with melanoma between 2003-2015.


RESULTS
The median elapsed time to BM (TTBM) was significantly associated with Breslow thickness, ulceration, location, and patient age. Head and neck location was the strongest predictor for early BM development [hazard ratio (HR)=1.81, 95% confidence interval (CI)=1.05-3.12; p=0.031) followed by Breslow thickness >2 mm (HR=1.53, 95% CI=1.04-2.23; p=0.027). Body part-specific median TTBM was 51.5, 43, 38.5, 32, 35, 36.5, 35.5 and 19 months in leg-foot, thigh, abdomen-pelvic, chest-back, lower arm-hand, upper arm-shoulder, face-neck and scalp regions, respectively.


CONCLUSIONS
We suggest brain magnetic resonance imaging follow-up in the high-risk patient group of patients with melanoma in the head and neck region, especially for those with primary melanoma over Breslow 2 mm located in the scalp.
Department of Dermato-oncology, National Institute of Oncology, Budapest, Hungary goreszter@yahoo.com.
Eszter
E
Gorka
Epilepsy Centre, Department of Neurology, National Institute of Clinical Neurosciences, Budapest, Hungary.
Dániel
D
Fabó
Department of Genetics, Cell and Immunbiology, Semmelweis University, Budapest, Hungary.
András
A
Gézsi
Department of Dermato-oncology, National Institute of Oncology, Budapest, Hungary.
Kata
K
Czirbesz
Department of Dermato-oncology, National Institute of Oncology, Budapest, Hungary.
Gabriella
G
Liszkay
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged
brain metastases; distance; head and neck; location; melanoma; predictive factors; scalp