Prognostic factors and impact of treatment in melanoma brain metastases:: Better prognosis for women?

Background: Brain metastases are a common consequence in patients with stage IV melanoma associated with a grim prognosis. Objective: The objective of this study was the examination of prognostic factors and the evaluation of different treatment options. Methods: A consecutive series of 133 patients with melanoma brain metastases with regard to prognostic factors and the impact on survival were analyzed. Results: 82 patients had involvement of only the cerebrum at the initial diagnosis, whereas in 7 patients only the cerebellum and the brainstem were involved. Seizures (n = 29) were the single most often reported symptom. The overall median survival time was 24 weeks (1 - 196) from diagnosis of brain metastases. Women had a significantly longer survival with 36 weeks (3 - 196) compared to 17 weeks (1 - 159) for men. Multivariate analysis has established as significant prognostic factors: female gender, number of brain metastases, surgery, chemotherapy, radiotherapy and corticosteroid application. Conclusion: With regard to the prognostic factors, an improved survival can be achieved in this patient group using more elective treatment options, also with emphasis on corticosteroids. Copyright (c) 2007 S. Karger AG, Basel