التفاصيل البيبلوغرافية
| العنوان: |
Predictive and Prognostic Factors in Melanoma Central Nervous System Metastases—A Cohort Study. |
| المؤلفون: |
Serra, Estefania1 (AUTHOR) nia720@hotmail.com, Abarzua-Araya, Álvaro1,2 (AUTHOR) alvaroabarzuaaraya@gmail.com, Arance, Ana3 (AUTHOR) amarance@clinic.cat, Martin-Huertas, Roberto3 (AUTHOR) rmartinh@clinic.cat, Aya, Francisco3 (AUTHOR), Olondo, María Lourdes4 (AUTHOR) mlolondo@clinic.cat, Rizo-Potau, Daniel1 (AUTHOR) danielrizopotau@msn.com, Malvehy, Josep1,5,6 (AUTHOR) jmalvehy@gmail.com, Puig, Susana1,5,6 (AUTHOR) susipuig@gmail.com, Carrera, Cristina1,5,6 (AUTHOR) ccarrera@clinic.cat, Podlipnik, Sebastian1,5 (AUTHOR) |
| المصدر: |
Cancers. Jun2024, Vol. 16 Issue 12, p2272. 14p. |
| مصطلحات موضوعية: |
*BRAIN tumor risk factors, *RISK assessment, *CANCER treatment, *PREDICTION models, *RESEARCH funding, *CANCER invasiveness, *MULTIPLE regression analysis, *TUMOR markers, *DESCRIPTIVE statistics, *AGE distribution, *LACTATE dehydrogenase, *MENINGEAL cancer, *CANCER patients, *METASTASIS, *LONGITUDINAL method, *KAPLAN-Meier estimator, *SURVIVAL analysis (Biometry), *TORSO, *CUTANEOUS malignant melanoma, *BRAIN tumors, *SPECIALTY hospitals, *REGRESSION analysis, *PROPORTIONAL hazards models, *SKIN ulcers, *DISEASE risk factors, *DISEASE complications |
| مصطلحات جغرافية: |
SPAIN |
| مستخلص: |
Simple Summary: We conducted a study at the Melanoma Unit of the Hospital Clinic of Barcelona to investigate brain metastases in patients with cutaneous melanoma. We collected data from patients diagnosed between January 1998 and September 2023. Patients with melanoma in situ or those with prior lung or breast cancer were excluded. Our aim was to identify factors associated with the development and survival outcomes of brain metastases. We analyzed patient demographics, tumor characteristics, and survival data. The diagnosis of brain metastases was confirmed using imaging techniques, and biopsies were performed when feasible. Our study followed strict guidelines for reporting observational studies. We found that younger age and larger primary tumor thickness increased the risk of developing brain metastases. Additionally, the presence of ulceration and microscopic satellitosis in the primary tumor were associated with a higher risk. Melanomas located on the trunk had a higher risk compared to those on the extremities. Patients with brain metastases had a median survival of around six months. Neurological symptoms and leptomeningeal involvement were associated with poorer survival outcomes. Higher number of brain lesions and elevated levels of lactate dehydrogenase (LDH) also predicted worse survival. Our findings highlight the importance of early detection and monitoring of melanoma patients, especially those at higher risk of brain metastases. Understanding these factors can aid in personalized treatment approaches and improving patient outcomes. Background: Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer. Objective: To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: A cohort study (1998–2023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival. Results: Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate ≥ 1 mm2, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival. Conclusion: Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites. [ABSTRACT FROM AUTHOR] |
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