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Predicting the development of brain metastases in patients with local/regional melanoma
Author(s) -
Frankel Timothy L.,
Bamboat Zubin M.,
Ariyan Charlotte,
Coit Daniel,
Sabel Michael S.,
Brady Mary S.
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23574
Subject(s) - medicine , melanoma , breslow thickness , brain metastasis , univariate analysis , stage (stratigraphy) , metastasis , head and neck , oncology , surgery , cancer , multivariate analysis , breast cancer , paleontology , sentinel lymph node , cancer research , biology
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. J. Surg. Oncol. 2014 109:770–774 . © 2014 Wiley Periodicals, Inc.