BACKGROUND: This multicenter study aimed to identify prognostic factors in patients with brain metastases from malignant melanoma (BM-MM). METHODS: In a retrospective survey in 9 cancer centers of the German Cancer Society, 692 patients were identified with BM-MM during the period 1986 through 2007. Overall survival was analyzed using a Kaplan-Meier estimator and compared with log-rank analysis. Cox proportional hazards models were used to identify prognostic factors significant for survival. RESULTS: The median overall survival of the entire cohort was 5.0 months (95% confidence interval [95% CI], 4 months-5 months). Significant prognostic factors in the univariate Kaplan-Meier analysis were Karnofsky performance status (≥70% vs <70%; P < .001), number of BM-MM (single vs multiple; P < .001), pretreatment levels of lactate dehydrogenase (LDH) (normal vs elevated; P < .001) and S-100 (normal vs elevated; P < .001), prognostic groups according to Radiation Therapy Oncology Group (class I vs class II vs class III; P = .0485), and treatment choice (for the cohort with single BM-MM only) (stereotactic radiotherapy or neurosurgical metastasectomy vs others; P = .036). Cox proportional hazards models revealed pretreatment elevated level of serum LDH (hazard ratio [HR], 1.6; 95% CI, 1.3-2.0 [P = .00013]) and number of BM-MM (HR, 1.6; 95% CI, 1.3-2.0 [P = .00011]) to be independent prognostic variables in the entire cohort, whereas in patients with a single BM-MM, treatment choice (HR, 1.5; 95% CI, 1.1-1.9 [P = .0061]) was identified as a unique prognostic factor. CONCLUSIONS: The overall survival of patients with BM-MM primarily depends on the number of metastases and pretreatment level of LDH. In the case of a single brain metastasis, stereotactic radiotherapy or neurosurgical metastasectomy is by far the most important factor for improving survival.
BACKGROUND: This multicenter study aimed to identify prognostic factors in patients with brain metastases from malignant melanoma (BM-MM). METHODS: In a retrospective survey in 9 cancer centers of the German Cancer Society, 692 patients were identified with BM-MM during the period 1986 through 2007. Overall survival was analyzed using a Kaplan-Meier estimator and compared with log-rank analysis. Cox proportional hazards models were used to identify prognostic factors significant for survival. RESULTS: The median overall survival of the entire cohort was 5.0 months (95% confidence interval [95% CI], 4 months-5 months). Significant prognostic factors in the univariate Kaplan-Meier analysis were Karnofsky performance status (≥70% vs <70%; P < .001), number of BM-MM (single vs multiple; P < .001), pretreatment levels of lactate dehydrogenase (LDH) (normal vs elevated; P < .001) and S-100 (normal vs elevated; P < .001), prognostic groups according to Radiation Therapy Oncology Group (class I vs class II vs class III; P = .0485), and treatment choice (for the cohort with single BM-MM only) (stereotactic radiotherapy or neurosurgical metastasectomy vs others; P = .036). Cox proportional hazards models revealed pretreatment elevated level of serum LDH (hazard ratio [HR], 1.6; 95% CI, 1.3-2.0 [P = .00013]) and number of BM-MM (HR, 1.6; 95% CI, 1.3-2.0 [P = .00011]) to be independent prognostic variables in the entire cohort, whereas in patients with a single BM-MM, treatment choice (HR, 1.5; 95% CI, 1.1-1.9 [P = .0061]) was identified as a unique prognostic factor. CONCLUSIONS: The overall survival of patients with BM-MM primarily depends on the number of metastases and pretreatment level of LDH. In the case of a single brain metastasis, stereotactic radiotherapy or neurosurgical metastasectomy is by far the most important factor for improving survival.
Authors: Mark B Faries; Anna Leung; Donald L Morton; Danielle Hari; Ji-Hey Lee; Myung-shin Sim; Anton J Bilchik Journal: J Am Coll Surg Date: 2014-05-10 Impact factor: 6.113
Authors: Ines Pires da Silva; Isabella C Glitza; Lauren E Haydu; Romany Johnpulle; Patricia D Banks; George D Grass; Simone M A Goldinger; Jessica L Smith; Ashlyn S Everett; Peter Koelblinger; Rachel Roberts-Thomson; Michael Millward; Victoria G Atkinson; Alexander Guminski; Rony Kapoor; Robert M Conry; Matteo S Carlino; Wei Wang; Mark J Shackleton; Zeynep Eroglu; Serigne Lo; Angela M Hong; Georgina V Long; Douglas B Johnson; Alexander M Menzies Journal: Pigment Cell Melanoma Res Date: 2019-03-03 Impact factor: 4.693
Authors: Diego M Marzese; Richard A Scolyer; Maria Roqué; Laura M Vargas-Roig; Jamie L Huynh; James S Wilmott; Rajmohan Murali; Michael E Buckland; Garni Barkhoudarian; John F Thompson; Donald L Morton; Daniel F Kelly; Dave S B Hoon Journal: Neuro Oncol Date: 2014-06-26 Impact factor: 12.300
Authors: Jadwiga Nowak-Sadzikowska; Tomasz Walasek; Jerzy Jakubowicz; Paweł Blecharz; Marian Reinfuss Journal: Rep Pract Oncol Radiother Date: 2015-12-29