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Predictive factors for the development of brain metastases in patients with malignant melanoma: a study by the Anatolian society of medical oncology
Authors:Ozge Gumusay  Ugur Coskun  Tülay Akman  Ahmet Siyar Ekinci  Muharrem Kocar  Özlem Balvan Erceleb  Ozan Yazıcı  Mehmet Ali Kaplan  Veli Berk  Bulent Cetin  Burcu Yapar Taskoylu  Ayhan Yildiz  Gamze Goksel  Ahmet Alacacioglu  Umut Demirci  Efnan Algin  Mukremin Uysal  Ilhan Oztop  Berna Oksuzoglu  Faysal Dane  Mahmut Gumus  Suleyman Buyukberber
Affiliation:1. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Besevler, Ankara, 06500, Turkey
2. Division of Medical Oncology, Department of Internal Medicine, Bal?kesir State Hospital, Bal?kesir, Turkey
3. Division of Medical Oncology, Department of Internal Medicine, Dr. Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Turkey
4. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey
5. Division of Medical Oncology, Department of Internal Medicine, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
6. Department of Internal Medicine, Division of Medical Oncology, Numune Training and Research Hospital, Ankara, Turkey
7. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
8. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey
9. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
10. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Inonu University, Malatya, Turkey
11. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
12. Division of Medical Oncology, Department of Internal Medicine, Izmir Katip Celebi University Atatürk Training and Research Hospital, Izmir, Turkey
13. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
14. Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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.

Patients and 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.
Keywords:
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