Predicting the development of brain metastases in patients with local/regional melanoma. Academic Article uri icon

Overview

abstract

  • BACKGROUND: The brain is a common site of recurrence in melanoma patients. Brain recurrence may present as a seizure, hemorrhage, or death. We sought to determine predictors of brain metastases in patients with primary and regional melanoma in order to facilitate targeted screening. METHODS: Prospectively maintained databases were used to identify patients treated for local or regional melanoma who developed stage IV melanoma with and without brain metastasis at initial recurrence. One hundred twenty patients were identified with brain relapse and compared to 487 patients without brain recurrence. RESULTS: On univariate analysis, patients with brain metastases were younger (55 vs. 59yrs, P = 0.04) but did not differ in primary site (head and neck 23% vs. 21%, P = 0.20). Brain metastasis patients had thinner primaries (mean 3.4 vs. 4.5 mm, P = 0.01). There were no other pathologic differences including ulceration (55% vs. 53%, P = 0.75), mitoses (7 vs.7.5, P = 0.61) or histologic subtype. Younger age and decreased Breslow thickness were independently associated with brain metastases at stage IV recurrence (OR = 1.10 P = 0.01 and OR = 1.02 P = 0.02, respectively). CONCLUSIONS: Our analysis, the largest to date, demonstrates that thinner Breslow depth and younger age were associated with brain recurrence at first presentation with Stage IV disease.

publication date

  • February 20, 2014

Research

keywords

  • Brain Neoplasms
  • Melanoma
  • Neoplasm Recurrence, Local
  • Skin Neoplasms

Identity

Scopus Document Identifier

  • 84900536216

Digital Object Identifier (DOI)

  • 10.1002/jso.23574

PubMed ID

  • 24862924

Additional Document Info

volume

  • 109

issue

  • 8