Incidence and prognosis of brain metastases in cutaneous melanoma patients: a population-based study

Abstract

Brain metastases (BM) from cutaneous melanoma are associated with poor prognosis. Population-based data describing the associated factors of incidence and prognosis of BM from melanoma are still lacking. We identified 121 255 melanoma patients diagnosed during 2010–2015 from the Surveillance, Epidemiology, and End Results program, and identified predictive factors for incidence and survival of BM patients by using multivariable logistic and Cox’s proportional hazard regression, respectively. We identified 1547 patients with BM at the time of diagnosis of malignant cutaneous melanoma, representing 1.3% of the entire cohort and 35.4% of the subset with metastatic disease. The characteristics associated with higher BM incidence were male sex, age 40–60 years, melanoma location of face/head/neck, histologic type of nodular, higher T-stage, ulceration and extracranial metastases. The median overall survival and median cutaneous melanoma specific survival of patients with BM was 5 and 6 months, respectively. The relative factors of poor survival were older age and more extracranial metastatic sites. In summary, we provided insight into the epidemiology of BM from cutaneous melanoma. These results may provide significant help to improve the screening strategy of BM strategy and update the existing prognosis evaluation system.

An Italian Retrospective Survey on Bone Metastasis in Melanoma: Impact of Immunotherapy and Radiotherapy on Survival

“…Other studies describing a modest incidence of bone involvement at diagnosis of metastatic melanoma probably reflect the fact that the BD was not properly suspected and investigated at diagnosis. However, one-fourth (23.9%) of melanoma patients from our series showed a brain involvement which is instead reported in about 40-60% of the general melanoma population (24). This apparent difference from our data may probably imply specific molecular mechanisms which critically drive the osteotropism of melanoma cells like those affecting the SDF1/CXCR7/CXCR4 pathway, as recently proven (25,26).…”

Prognostic Value of Bone Marrow Metabolism on Pretreatment 18F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy

“…The difference between the current study and the previous one is that we analyzed a larger number of patients (n = 92) and included patients with brain metastasis. Brain metastasis is not less frequent in patients with advanced melanoma who receive immunotherapy (16); in fact, 28.6% of our patients had brain metastasis before immunotherapy.…”

Melanoma-secreted Amyloid Beta Suppresses Neuroinflammation and Promotes Brain Metastasis

“…40-75% of Stage IV melanoma patients develop brain metastasis 2, 3 , reflecting melanoma’s striking ability to colonize the brain. Brain metastases are less responsive than extracranial metastases to current cancer therapies 4–6 , and the majority of patients succumb to disease in less than one year 7 . Furthermore, patients with brain metastasis are often excluded from clinical trials and urgently need new clinical options.…”